Individual provider Active NPI

Stacy Marie Carone, MA, ATC, LAT, CSCS

  • Athletic Trainer
  • Villanova, PA
National Provider Identifier
1679939250
Registry record updated Jan 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
RT004210 Issued in PA
Practice address
800 E Lancaster Ave
Davis Center First Floor
Villanova, PA 19085-1603
Phone
(610) 519-4557
NPI assigned
Jan 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2016

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 RT004210 PA Primary

Addresses

Primary practice location

800 E Lancaster Ave
Davis Center First Floor
Villanova, PA 19085-1603

Mailing address

800 E Lancaster Ave
Davis Center First Floor
Villanova, PA 19085-1603
Phone (610) 519-4557

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 Arts

State licenses

LicenseStateTypeSpecialty
RT004210PAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1679939250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E LANCASTER AVE",
            "address_2": "DAVIS CENTER FIRST FLOOR",
            "city": "VILLANOVA",
            "state": "PA",
            "postal_code": "190851603",
            "telephone_number": "610-519-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E LANCASTER AVE",
            "address_2": "DAVIS CENTER FIRST FLOOR",
            "city": "VILLANOVA",
            "state": "PA",
            "postal_code": "190851603",
            "telephone_number": "610-519-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARONE",
        "first_name": "STACY",
        "middle_name": "MARIE",
        "credential": "MA, ATC, LAT, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-12",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT004210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villanova, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; 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.