Active NPI
Anthony Michael Egan, ATC
- Athletic Trainer
- Branchburg, NJ
National Provider Identifier
1104246990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 25MT00101500
- Practice address
- 211 Bernard St
Branchburg, NJ 08876-3754 - Phone
- (908) 255-4242
- NPI assigned
- Apr 21, 2014
- 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 | 25MT00101500 | NJ | Primary |
Addresses
Primary practice location
211 Bernard St
Branchburg, NJ 08876-3754
Mailing address
211 Bernard St
Branchburg, NJ 08876-3754
Phone (908) 255-4242
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 |
|---|---|---|---|
| 25MT00101500 | NJ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398038400000",
"number": "1104246990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 BERNARD ST",
"city": "BRANCHBURG",
"state": "NJ",
"postal_code": "088763754",
"telephone_number": "908-255-4242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 BERNARD ST",
"city": "BRANCHBURG",
"state": "NJ",
"postal_code": "088763754",
"telephone_number": "908-255-4242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGAN",
"first_name": "ANTHONY",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-04-21",
"last_updated": "2014-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NJ",
"license": "25MT00101500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Branchburg, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.