Active NPI
Kevin Peter O'Neill, M.S., A.T.C.
- Athletic Trainer
- Davie, FL
National Provider Identifier
1023135308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL 541
- Practice address
- 7500 SW 30TH St
Davie, FL 33314-1020 - Phone
- (954) 452-7030
- Fax
- (954) 452-7069
- NPI assigned
- Mar 23, 2007
- 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 | AL 541 | FL | Primary |
Addresses
Primary practice location
7500 SW 30TH St
Davie, FL 33314-1020
Mailing address
7500 SW 30TH St
Davie, FL 33314-1020
Phone (954) 452-7030
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL 541 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023135308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7500 SW 30TH ST",
"city": "DAVIE",
"state": "FL",
"postal_code": "333141020",
"telephone_number": "954-452-7030",
"fax_number": "954-452-7069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7500 SW 30TH ST",
"city": "DAVIE",
"state": "FL",
"postal_code": "333141020",
"telephone_number": "954-452-7030",
"fax_number": "954-452-7069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'NEILL",
"first_name": "KEVIN",
"middle_name": "PETER",
"name_prefix": "Mr.",
"credential": "M.S., A.T.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL 541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.