Individual provider Active NPI

Emily Durand, ATC

  • Athletic Trainer
  • Gulf Breeze, FL
National Provider Identifier
1053700773
Registry record updated Jan 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL3579 Issued in FL
Practice address
1040 Gulf Breeze Pkwy
Suite 210
Gulf Breeze, FL 32561-7809
Phone
(850) 916-8455
NPI assigned
Jan 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AL3579 FL Primary

Addresses

Primary practice location

1040 Gulf Breeze Pkwy
Suite 210
Gulf Breeze, FL 32561-7809

Mailing address

3331 Summit Blvd Apt 126
Pensacola, FL 32503-4327
Phone (317) 627-1050

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

LicenseStateTypeSpecialty
AL3579FLMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421625600000",
    "number": "1053700773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3331 SUMMIT BLVD APT 126",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325034327",
            "telephone_number": "317-627-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 GULF BREEZE PKWY",
            "address_2": "SUITE 210",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325617809",
            "telephone_number": "850-916-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURAND",
        "first_name": "EMILY",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-19",
        "last_updated": "2015-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL3579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.

Verify at the official NPI Registry.