Aimee Petrides

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A0000875 Issued in MD

Practice address

101 Braddock Rd
Frostburg, MD 21532-2303

Phone

(301) 687-3702

NPI assigned

Dec 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• N/a N/a N/a Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1679088744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 DEVERON RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212868813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BRADDOCK RD",
            "city": "FROSTBURG",
            "state": "MD",
            "postal_code": "215322303",
            "telephone_number": "301-687-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIDES",
        "first_name": "AIMEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-11",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0000875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "middle_name": "N/A",
            "credential": "LAT, ATC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Op Frostburg, LLC
• Jacqueline Renee Palaisa, DMD, MS
• Makayla Parris
• Taylor Patrick
• Pelvic Floor Functions: a Women'S Health LLC
• Janalene Phillips, PA-STUDENT
• Raven M Pratt
• Qinzhuola Qi, DDS
• Debra Reckart, PTA
• Trina Paris Redmond-Matz, PH.D.

• Athletic Trainer in Frostburg, MD
• Providers in Frostburg, MD by specialty
• Athletic Trainer in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; 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.