Active NPI
Morgan Melquist
- Athletic Trainer
- Westmont, IL
National Provider Identifier
1780151407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096005627
- Practice address
- 816 S Adams St Apt B605
Westmont, IL 60559-3614 - Phone
- (716) 720-2230
- NPI assigned
- Oct 31, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 096005627 | IL | Primary |
Addresses
Primary practice location
816 S Adams St Apt B605
Westmont, IL 60559-3614
Mailing address
816 S Adams St Apt B605
Westmont, IL 60559-3614
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 096005627 | Other | IL | IDFPR STATE LICENSURE FOR ATHLETIC TRAINERS |
| 00000000000 | Other | N/A | |
| 2000035346 | Other | ATHLETIC TRAINING BOARD OF CERTIFICATION (BOC) |
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 |
|---|---|---|---|
| 096005627 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679443200000",
"number": "1780151407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "816 S ADAMS ST APT B605",
"city": "WESTMONT",
"state": "IL",
"postal_code": "605593614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "816 S ADAMS ST APT B605",
"city": "WESTMONT",
"state": "IL",
"postal_code": "605593614",
"telephone_number": "716-720-2230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELQUIST",
"first_name": "MORGAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-31",
"last_updated": "2023-03-22",
"certification_date": "2023-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096005627",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDFPR STATE LICENSURE FOR ATHLETIC TRAINERS",
"identifier": "096005627",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "N/A",
"identifier": "00000000000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATHLETIC TRAINING BOARD OF CERTIFICATION (BOC)",
"identifier": "2000035346",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Westmont, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.