Active NPI
Zachary Olivarez
- Athletic Trainer
- Riverton, WY
National Provider Identifier
1043691835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- ATC-097
- Practice address
- 2002 W Sunset Dr
Suite 1
Riverton, WY 82501-2283 - Phone
- (307) 856-7021
- Fax
- (307) 856-5546
- NPI assigned
- Jun 17, 2015
- Last updated
- Jun 17, 2015
- 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 | ATC-097 | WY | Primary |
Addresses
Primary practice location
2002 W Sunset Dr
Suite 1
Riverton, WY 82501-2283
Mailing address
1102 West Spruce Street
Rawlins, WY 82301-4850
Phone (307) 370-9175
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 |
|---|---|---|---|
| ATC-097 | WY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434499200000",
"number": "1043691835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1102 WEST SPRUCE STREET",
"city": "RAWLINS",
"state": "WY",
"postal_code": "823014850",
"telephone_number": "307-370-9175",
"fax_number": "307-370-9177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2002 W SUNSET DR",
"address_2": "SUITE 1",
"city": "RIVERTON",
"state": "WY",
"postal_code": "825012283",
"telephone_number": "307-856-7021",
"fax_number": "307-856-5546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVAREZ",
"first_name": "ZACHARY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-17",
"last_updated": "2015-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WY",
"license": "ATC-097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverton, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.