Carlo Anthony Mercadante, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT005058 Issued in PA

Practice address

201 N Sprague Ave
Kingston, PA 18704-3506

Phone

(570) 710-4030

NPI assigned

May 10, 2022

Last updated

May 10, 2022By the provider in NPPES

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": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1801532056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 W PETTEBONE ST",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "187043925",
            "telephone_number": "570-710-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N SPRAGUE AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043506",
            "telephone_number": "570-710-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADANTE",
        "first_name": "CARLO",
        "middle_name": "ANTHONY",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-10",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT005058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• William R Mericle, LCSW
• Leah Alexandra Merrick, PA-C
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• Michael F. Lombard MD Stanley a. Lobitz MD Gen PTRS
• Michele Mattie, PHD, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.