Individual provider Active NPI

Paul Fleury, ATC

  • Athletic Trainer
  • Milton, MA
National Provider Identifier
1992163877
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2258 Issued in MA
Practice address
1071 Blue Hill Avenue
Milton, MA 02186-2395
Phone
(617) 333-2376
NPI assigned
Feb 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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 2258 MA Primary

Addresses

Primary practice location

1071 Blue Hill Avenue
Milton, MA 02186-2395

Mailing address

3101 Summit Dr
Bridgewater, MA 02324-2163

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

LicenseStateTypeSpecialty
2258MAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1992163877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 SUMMIT DR",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023242163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 BLUE HILL AVENUE",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021862395",
            "telephone_number": "617-333-2376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEURY",
        "first_name": "PAUL",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-05",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "2258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; 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.