Marissa Vane, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2446 Issued in MA

Practice address

1419 Commonwealth Ave
Apartment 504
Boston, MA 02135-6253

Phone

(408) 398-5578

NPI assigned

May 21, 2014

Sex

Female

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": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407456000000",
    "number": "1659783868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ENDICOTT ST",
            "address_2": "#3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021131668",
            "telephone_number": "408-398-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 COMMONWEALTH AVE",
            "address_2": "APARTMENT 504",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021356253",
            "telephone_number": "408-398-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANE",
        "first_name": "MARISSA",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-21",
        "last_updated": "2014-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "2446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Anne Vanderwall, MS, MPH
• Shannon Vandevoordt, RN, CLC
• Lawren A Vandevrede, MD, PHD
• Jessica Vandoren, CRNA, DNP
• Diane M Vandover, NP
• Yanzel Vanegas
• Sally S Vanerian, M.D.
• Gregory Alan Vangordon, D.M.D
• Rebecca Vangsness
• Mary Ellen Vanhauser, RN

• Athletic Trainer in Boston, MA
• Providers in Boston, MA by specialty
• Athletic Trainer in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; 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.