Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Michael Matthew Novellino, LAT, ATC, CEASIII

Individual provider Athletic Trainer · NPI 1720435456

Mr. Michael Matthew Novellino, LAT, ATC, CEASIII is an Athletic Trainer in Moraine, Ohio. Licensed in Ohio. Registered with an NPI since 2016.

Licensed in
OH
In the registry since
2016
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

800 Fuyao Ave
Moraine, OH 45439-7500
Phone: (937) 493-5777
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT005847 (OH)

Record details

NPI number1720435456
Entity typeIndividual (Type 1)
GenderMale
Credentials LAT , ATC , CEASIII
Sole proprietorNo
NPI enumeratedMay 23, 2016
Last updated in NPPESMay 6, 2020
Certification dateMay 6, 2020