Active NPI
Susan L Courchesne, ATC
- Athletic Trainer
- Melrose, MA
National Provider Identifier
1598966384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 308
- Practice address
- 585 Lebanon St
Melrose, MA 02176-3225 - Phone
- (781) 979-3563
- NPI assigned
- May 30, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 308 | MA | Primary |
Addresses
Primary practice location
585 Lebanon St
Melrose, MA 02176-3225
Mailing address
2 Ruby Rd
Saugus, MA 01906-3922
Phone (781) 941-8109
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
| License | State | Type | Specialty |
|---|---|---|---|
| 308 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598966384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 RUBY RD",
"city": "SAUGUS",
"state": "MA",
"postal_code": "019063922",
"telephone_number": "781-941-8109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "585 LEBANON ST",
"city": "MELROSE",
"state": "MA",
"postal_code": "021763225",
"telephone_number": "781-979-3563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COURCHESNE",
"first_name": "SUSAN",
"middle_name": "L",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melrose, MA
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.