Emily Ruth Chadwick, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

003135 Issued in NY

Practice address

30 Terrace Cir Apt 1C
Great Neck, NY 11021-4187

Phone

(603) 491-8065

NPI assigned

Nov 15, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1730692534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 TERRACE CIR APT 1C",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214187",
            "telephone_number": "603-491-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 TERRACE CIR APT 1C",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214187",
            "telephone_number": "603-491-8065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "341 Lakeville Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Success",
            "state": "NY",
            "postal_code": "110201639",
            "country_code": "US",
            "telephone_number": "516-441-4852",
            "fax_number": "516-441-4895",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "90 E Shore Rd",
            "address_purpose": "LOCATION",
            "city": "Great Neck",
            "state": "NY",
            "postal_code": "110232409",
            "country_code": "US",
            "telephone_number": "516-684-1122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHADWICK",
        "first_name": "EMILY",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "003135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.