Salvatore Louis Nicosia Jr.

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

202 Pepper Ridge Dr
Spring Mills, PA 16875-9339

Phone

(814) 876-0390

NPI assigned

Dec 21, 2019

Last updated

Dec 21, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1576886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576886400000",
    "number": "1477192417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 PEPPER RIDGE DR",
            "city": "SPRING MILLS",
            "state": "PA",
            "postal_code": "168759339",
            "telephone_number": "814-876-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 PEPPER RIDGE DR",
            "city": "SPRING MILLS",
            "state": "PA",
            "postal_code": "168759339",
            "telephone_number": "814-876-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOSIA",
        "first_name": "SALVATORE",
        "middle_name": "LOUIS",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-21",
        "last_updated": "2019-12-21",
        "certification_date": "2019-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Spring Mills, PA
• Providers in Spring Mills, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2019; 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.