Active NPI
Jonathan Edward Dicandilo, ATC, CSCS
- Athletic Trainer
- Pottstown, PA
National Provider Identifier
1710264163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT002231A
- Practice address
- 324 Highland Rd
Pottstown, PA 19464-4408 - Phone
- (610) 705-0630
- NPI assigned
- Nov 14, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT002231A | PA | Primary |
Addresses
Primary practice location
324 Highland Rd
Pottstown, PA 19464-4408
Mailing address
324 Highland Rd
Pottstown, PA 19464-4408
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
| License | State | Type | Specialty |
|---|---|---|---|
| RT002231A | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321228800000",
"number": "1710264163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 HIGHLAND RD",
"city": "POTTSTOWN",
"state": "PA",
"postal_code": "194644408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "324 HIGHLAND RD",
"city": "POTTSTOWN",
"state": "PA",
"postal_code": "194644408",
"telephone_number": "610-705-0630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICANDILO",
"first_name": "JONATHAN",
"middle_name": "EDWARD",
"credential": "ATC, CSCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-14",
"last_updated": "2011-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT002231A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pottstown, PA
- Diakon Child, Family & Community
- Diakon Lutheran Social Ministries
- Diakon Lutheran Social Ministries
- Madeleine Mary Diantonio, RD, LDN
- Alexis Diaz, MA, MFT
- Gregory Dickey
- Anthony Albert Didonato Jr., OTR/L
- Lisa G. Digiorgio, MPT
- Digital Hearing Aid Systems, Inc
- Annette Eve Dilworth, LMT, CLT, CIMT, CPMT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.