Individual provider Active NPI

Melissa Marie Stavinski, MS, ATC

  • Athletic Trainer
  • Wilkes Barre, PA
National Provider Identifier
1538240452
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
RT003326 Issued in PA
Practice address
133 N River St
Wilkes Barre, PA 18711-0800
Phone
(570) 208-5900
Fax
(570) 208-6016
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT003326 PA Primary

Addresses

Primary practice location

133 N River St
Wilkes Barre, PA 18711-0800

Mailing address

115 S Meade St
Wilkes Barre, PA 18702-6331

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

LicenseStateTypeSpecialty
RT003326PAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
King'S College Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1538240452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S MEADE ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187026331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 N RIVER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110800",
            "telephone_number": "570-208-5900",
            "fax_number": "570-208-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVINSKI",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MS, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT003326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.