Active NPI
Kevin J Melanson, ATC, PES
- Athletic Trainer
- North Andover, MA
National Provider Identifier
1962768739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 972904
- Practice address
- 315 Turnpike St
North Andover, MA 01845-5806 - Phone
- (978) 857-6016
- NPI assigned
- Apr 6, 2012
- Sex
- Male
- 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 | 972904 | MA | Primary |
Addresses
Primary practice location
315 Turnpike St
North Andover, MA 01845-5806
Mailing address
315 Turnpike St
North Andover, MA 01845-5806
Phone (978) 857-6016
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 |
|---|---|---|---|
| 972904 | MA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333670400000",
"number": "1962768739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 TURNPIKE ST",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018455806",
"telephone_number": "978-857-6016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 TURNPIKE ST",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018455806",
"telephone_number": "978-857-6016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELANSON",
"first_name": "KEVIN",
"middle_name": "J",
"credential": "ATC, PES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-06",
"last_updated": "2012-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "972904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.