Active NPI
Melissa Ann Wilson, MS ATC
- Athletic Trainer
- Rochester, NY
National Provider Identifier
1487797288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 001303-1
- Practice address
- 120 Erie Canal Dr
Rochester, NY 14626-4607 - Phone
- (585) 225-6296
- NPI assigned
- Feb 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 001303-1 | NY | Primary |
Addresses
Primary practice location
120 Erie Canal Dr
Rochester, NY 14626-4607
Mailing address
656 Morgan Rd
Scottsville, NY 14546-9754
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001303-1 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487797288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "656 MORGAN RD",
"city": "SCOTTSVILLE",
"state": "NY",
"postal_code": "145469754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 ERIE CANAL DR",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146264607",
"telephone_number": "585-225-6296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MELISSA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MS ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "001303-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.