Individual provider Active NPI

Abraham L Noll, ATC

  • Athletic Trainer
  • Atchison, KS
National Provider Identifier
1083094783
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
24-00878 Issued in KS
Practice address
820 Ravenhill Dr Ste 104
Atchison, KS 66002-9230
Phone
(913) 360-5829
Fax
(913) 674-2040
NPI assigned
Jun 8, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 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 24-00878 KS Primary

Addresses

Primary practice location

820 Ravenhill Dr Ste 104
Atchison, KS 66002-9230

Mailing address

820 Ravenhill Dr Ste 104
Atchison, KS 66002-9230
Phone (913) 360-5829

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
24-00878KSMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1083094783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 RAVENHILL DR STE 104",
            "city": "ATCHISON",
            "state": "KS",
            "postal_code": "660029230",
            "telephone_number": "913-360-5829",
            "fax_number": "913-674-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 RAVENHILL DR STE 104",
            "city": "ATCHISON",
            "state": "KS",
            "postal_code": "660029230",
            "telephone_number": "913-360-5829",
            "fax_number": "913-674-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLL",
        "first_name": "ABRAHAM",
        "middle_name": "L",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-08",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "24-00878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atchison, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.