Individual provider Active NPI

Noel Neptune, ATC

  • Athletic Trainer
  • Gorham, ME
National Provider Identifier
1437110079
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT571 Issued in ME
Practice address
37 College Ave
Gorham, ME 04038-1032
Phone
(207) 780-5023
NPI assigned
Mar 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health Educator 174H00000X AT001213 WV
Other Specialist/Technologist 246Z00000X AT. 002894 OH
Athletic Trainer 2255A2300X AT571 ME Primary

Addresses

Primary practice location

37 College Ave
Gorham, ME 04038-1032

Mailing address

37 College Ave
Gorham, ME 04038-1032
Phone (937) 728-8323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AT001213WVMDHealth Educator
AT571MEMDAthletic Trainer
AT. 002894OHMDOther Specialist/Technologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1437110079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 COLLEGE AVE",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381032",
            "telephone_number": "937-728-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 COLLEGE AVE",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381032",
            "telephone_number": "207-780-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEPTUNE",
        "first_name": "NOEL",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "WV",
            "license": "AT001213",
            "primary": false
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "OH",
            "license": "AT. 002894",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ME",
            "license": "AT571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gorham, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.