Individual provider Active NPI

Gennaro Manocchio, ATC

  • Athletic Trainer
  • Jamestown, NY
National Provider Identifier
1700802162
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
000261 Issued in NY
Practice address
350 E 2ND St
Jamestown High School
Jamestown, NY 14701-5623
Phone
(716) 483-3470
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 000261 NY Primary

Addresses

Primary practice location

350 E 2ND St
Jamestown High School
Jamestown, NY 14701-5623

Mailing address

859 Church Cross Rd
Frewsburg, NY 14738-9738
Phone (716) 569-2296

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

LicenseStateTypeSpecialty
000261NYMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700802162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 CHURCH CROSS RD",
            "city": "FREWSBURG",
            "state": "NY",
            "postal_code": "147389738",
            "telephone_number": "716-569-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E 2ND ST",
            "address_2": "JAMESTOWN HIGH SCHOOL",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147015623",
            "telephone_number": "716-483-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOCCHIO",
        "first_name": "GENNARO",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "000261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

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.

Verify at the official NPI Registry.