Active NPI
Cody James Parker, ATC
- Athletic Trainer
- Williston, VT
National Provider Identifier
1053723882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1040096671
- Practice address
- 426 Industrial Ave
Suite 190
Williston, VT 05495-4448 - Phone
- (802) 860-4360
- Fax
- (802) 488-3160
- NPI assigned
- May 28, 2014
- 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 | 1040096671 | VT | Primary |
Addresses
Primary practice location
426 Industrial Ave
Suite 190
Williston, VT 05495-4448
Mailing address
426 Industrial Ave
Suite 190
Williston, VT 05495-4448
Phone (802) 860-4360
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 |
|---|---|---|---|
| 1040096671 | VT | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PT 360 Inc | Athletic Trainer | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401235200000",
"number": "1053723882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "426 INDUSTRIAL AVE",
"address_2": "SUITE 190",
"city": "WILLISTON",
"state": "VT",
"postal_code": "054954448",
"telephone_number": "802-860-4360",
"fax_number": "802-488-3160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "426 INDUSTRIAL AVE",
"address_2": "SUITE 190",
"city": "WILLISTON",
"state": "VT",
"postal_code": "054954448",
"telephone_number": "802-860-4360",
"fax_number": "802-488-3160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "CODY",
"middle_name": "JAMES",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-28",
"last_updated": "2014-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "VT",
"license": "1040096671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williston, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.