Active NPI
Foti Evangelista, ATC, CAT(C), AT
- Athletic Trainer
- Toledo, OH
National Provider Identifier
1093277659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000034460
- Practice address
- 2801 W. Bancroft St.
Health and Human Services RM 2505L, Mail Stop 119
Toledo, OH 43606-3390 - Phone
- (419) 530-4241
- NPI assigned
- Apr 3, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT006015 | OH | |
| Athletic Trainer | 2255A2300X | 2-5536 | ZZ | |
| Athletic Trainer | 2255A2300X | 2000034460 | Primary |
Addresses
Primary practice location
2801 W. Bancroft St.
Health and Human Services RM 2505L, Mail Stop 119
Toledo, OH 43606-3390
Mailing address
691 Pierre Street
Laval, QUEBEC H7X3P4
CA
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 |
|---|---|---|---|
| AT006015 | OH | MD | Athletic Trainer |
| 2-5536 | ZZ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571788800000",
"number": "1093277659",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "691 PIERRE STREET",
"city": "LAVAL",
"state": "QUEBEC",
"postal_code": "H7X3P4"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 W. BANCROFT ST.",
"address_2": "HEALTH AND HUMAN SERVICES RM 2505L, MAIL STOP 119",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436063390",
"telephone_number": "419-530-4241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANGELISTA",
"first_name": "FOTI",
"name_prefix": "Mr.",
"credential": "ATC, CAT(C), AT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-03",
"last_updated": "2019-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "AT006015",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ZZ",
"license": "2-5536",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": "2000034460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.