Active NPI
Brett Colelli
- Student in an Organized Health Care Education/Training Program
- Garnet Valley, PA
National Provider Identifier
1730646159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 2117 Shadyside LN
Garnet Valley, PA 19060-2121 - Phone
- (610) 358-9369
- NPI assigned
- Feb 21, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
2117 Shadyside LN
Garnet Valley, PA 19060-2121
Mailing address
2117 Shadyside LN
Garnet Valley, PA 19060-2121
Phone (610) 358-9369
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550793600000",
"number": "1730646159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2117 SHADYSIDE LN",
"city": "GARNET VALLEY",
"state": "PA",
"postal_code": "190602121",
"telephone_number": "610-358-9369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2117 SHADYSIDE LN",
"city": "GARNET VALLEY",
"state": "PA",
"postal_code": "190602121",
"telephone_number": "610-358-9369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLELLI",
"first_name": "BRETT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-02-21",
"last_updated": "2019-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garnet Valley, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.