Individual provider Active NPI

Michele Ann Pallotta, LAT, ATC, M.ED.,

  • Athletic Trainer
  • Arnold, MD
National Provider Identifier
1851440069
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
A00210 Issued in MD
Practice address
1521 Ritchie Hwy
Suite 201
Arnold, MD 21012-2703
Phone
(410) 544-6038
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X A00210 MD Primary

Addresses

Primary practice location

1521 Ritchie Hwy
Suite 201
Arnold, MD 21012-2703

Mailing address

608 Admiral Dr
420
Annapolis, MD 21401-2184
Phone (216) 780-7799

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
A00210MDMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1851440069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 ADMIRAL DR",
            "address_2": "420",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012184",
            "telephone_number": "216-780-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 RITCHIE HWY",
            "address_2": "SUITE 201",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210122703",
            "telephone_number": "410-544-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLOTTA",
        "first_name": "MICHELE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LAT, ATC, M.ED.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A00210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arnold, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.