Individual provider Active NPI

Cassandra Mall, ATC, SCAT

  • Athletic Trainer
  • Melbourne, FL
National Provider Identifier
1659768885
Registry record updated Apr 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
1595 Issued in SC
Practice address
521 Briarcliff CT
Melbourne, FL 32940-8122
Phone
(321) 271-4028
NPI assigned
Apr 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2015

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 1595 SC Primary

Addresses

Primary practice location

521 Briarcliff CT
Melbourne, FL 32940-8122

Mailing address

521 Briarcliff CT
Melbourne, FL 32940-8122
Phone (321) 271-4028

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

NPI Registry JSON

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

{
    "created_epoch": "1430006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430006400000",
    "number": "1659768885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 BRIARCLIFF CT",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408122",
            "telephone_number": "321-271-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 BRIARCLIFF CT",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408122",
            "telephone_number": "321-271-4028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALL",
        "first_name": "CASSANDRA",
        "credential": "ATC, SCAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-26",
        "last_updated": "2015-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "1595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2015; 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.