Active NPI
Alan Mark Nasypany Jr.
- Athletic Trainer
- Moscow, ID
National Provider Identifier
1013799774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT307
- Practice address
- 875 Perimeter Dr Dept of
Moscow, ID 83844-9803 - Phone
- (208) 885-2185
- NPI assigned
- Oct 17, 2023
- 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 | AT307 | ID | Primary |
Addresses
Primary practice location
875 Perimeter Dr Dept of
Moscow, ID 83844-9803
Mailing address
1215 Tamarack Dr
Moscow, ID 83843-9438
Phone (208) 885-2185
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 |
|---|---|---|---|
| AT307 | ID | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697500800000",
"number": "1013799774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 TAMARACK DR",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838439438",
"telephone_number": "208-885-2185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 PERIMETER DR DEPT OF",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838449803",
"telephone_number": "208-885-2185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASYPANY",
"first_name": "ALAN",
"middle_name": "MARK",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-10-17",
"last_updated": "2023-10-17",
"certification_date": "2023-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ID",
"license": "AT307",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.