Mark Vincent Keppler, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT-00453-A Issued in PA

Practice address

Bucknell University
Moore Ave
Lewisburg, PA 17837

Phone

(570) 577-3255

NPI assigned

Nov 24, 2006

Sex

Male

Sole proprietor

No

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": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750456679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SOUTH 11TH STREET",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "17837",
            "telephone_number": "570-523-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUCKNELL UNIVERSITY",
            "address_2": "MOORE AVE",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "17837",
            "telephone_number": "570-577-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPPLER",
        "first_name": "MARK",
        "middle_name": "VINCENT",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT-00453-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Lewisburg, PA
• Providers in Lewisburg, PA by specialty
• Athletic Trainer in Pennsylvania

• 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.