Active NPI
Moreen Lily Wheatley, MS, ATC, LAT
- Athletic Trainer
- Bethlehem, PA
National Provider Identifier
1962229872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000030267
- Practice address
- 3300 Chester Ave
Bethlehem, PA 18020-2870 - Phone
- (610) 866-8013
- NPI assigned
- Sep 23, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 2000030267 | PA | Primary |
Addresses
Primary practice location
3300 Chester Ave
Bethlehem, PA 18020-2870
Mailing address
3300 Chester Ave
Bethlehem, PA 18020-2870
Phone (610) 866-8013
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000030267 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727049600000",
"number": "1962229872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 CHESTER AVE",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180202870",
"telephone_number": "610-866-8013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 CHESTER AVE",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180202870",
"telephone_number": "610-866-8013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEATLEY",
"first_name": "MOREEN",
"middle_name": "LILY",
"name_prefix": "Mrs.",
"credential": "MS, ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-23",
"last_updated": "2024-09-23",
"certification_date": "2024-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "2000030267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethlehem, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.