Individual provider Active NPI

Terry R Ventresca, ATC

  • Athletic Trainer
  • Wyomissing, PA
National Provider Identifier
1700879103
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
RT000529A Issued in PA
Practice address
1350 Broadcasting Rd
Ste 201
Wyomissing, PA 19610-3220
Phone
(610) 685-9600
Fax
(610) 685-6700
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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 RT000529A PA Primary

Addresses

Primary practice location

1350 Broadcasting Rd
Ste 201
Wyomissing, PA 19610-3220

Mailing address

1350 Broadcasting Rd
Ste 201
Wyomissing, PA 19610-3220
Phone (610) 685-9600

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
RT000529APAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1700879103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 BROADCASTING RD",
            "address_2": "STE 201",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103220",
            "telephone_number": "610-685-9600",
            "fax_number": "610-685-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BROADCASTING RD",
            "address_2": "STE 201",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103220",
            "telephone_number": "610-685-9600",
            "fax_number": "610-685-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTRESCA",
        "first_name": "TERRY",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT000529A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.