Active NPI
Brittany Pestak
- Athletic Trainer
- Mentor, OH
National Provider Identifier
1043610728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT006918
- Practice address
- 9772 Andrea Dr
Mentor, OH 44060-7209 - Phone
- (440) 547-6827
- NPI assigned
- Aug 29, 2014
- Last updated
- Oct 20, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Athletic Trainer | 2255A2300X | AT006918 | OH | Primary |
Addresses
Primary practice location
9772 Andrea Dr
Mentor, OH 44060-7209
Mailing address
9772 Andrea Dr
Mentor, OH 44060-7209
Phone (440) 547-6827
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 |
|---|---|---|---|
| AT006918 | OH | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760918400000",
"number": "1043610728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9772 ANDREA DR",
"city": "MENTOR",
"state": "OH",
"postal_code": "440607209",
"telephone_number": "440-547-6827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9772 ANDREA DR",
"city": "MENTOR",
"state": "OH",
"postal_code": "440607209",
"telephone_number": "440-547-6827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PESTAK",
"first_name": "BRITTANY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-29",
"last_updated": "2025-10-20",
"certification_date": "2025-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "AT006918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.