Active NPI
Robert O Ortiz Jr., MSC, ATC
- Athletic Trainer
- Phoenix, AZ
National Provider Identifier
1063848604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT.0001110
- Practice address
- 400 E Van Buren St
Suite 300
Phoenix, AZ 85004-2223 - Phone
- (602) 258-0000
- NPI assigned
- Sep 15, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | AT.0001110 | CO | Primary |
Addresses
Primary practice location
400 E Van Buren St
Suite 300
Phoenix, AZ 85004-2223
Mailing address
300 E Miller CT
P.O. Box #2048
Castle Rock, CO 80104-8436
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 |
|---|---|---|---|
| AT.0001110 | CO | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412640000000",
"number": "1063848604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MILLER CT",
"address_2": "P.O. BOX #2048",
"city": "CASTLE ROCK",
"state": "CO",
"postal_code": "801048436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E VAN BUREN ST",
"address_2": "SUITE 300",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850042223",
"telephone_number": "602-258-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "ROBERT",
"middle_name": "O",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "MSC, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-09-15",
"last_updated": "2014-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CO",
"license": "AT.0001110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.