Active NPI
Joseph Bernard Eberhardt, LAT, ATC
- Athletic Trainer
- San Angelo, TX
National Provider Identifier
1013360460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 2601 W Avenue N
San Angelo, TX 76909-5099 - Phone
- (713) 447-4965
- NPI assigned
- Jul 21, 2016
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
2601 W Avenue N
San Angelo, TX 76909-5099
Mailing address
2914 Abbey Field Dr
Pearland, TX 77584-8684
Other practice location 1
2914 Abbey Field Dr
Pearland, TX 77584-8684
Phone (713) 447-4965
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611100800000",
"number": "1013360460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2914 ABBEY FIELD DR",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775848684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 W AVENUE N",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769095099",
"telephone_number": "713-447-4965"
}
],
"practiceLocations": [
{
"address_1": "2914 Abbey Field Dr",
"address_purpose": "LOCATION",
"city": "Pearland",
"state": "TX",
"postal_code": "775848684",
"country_code": "US",
"telephone_number": "713-447-4965",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EBERHARDT",
"first_name": "JOSEPH",
"middle_name": "BERNARD",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-21",
"last_updated": "2021-01-20",
"certification_date": "2021-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Angelo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.