Corey M. Debarbrie, ATC, CSCS, CES
Individual provider Active NPI Athletic Trainer · Hill Afb, UT
NPI 1124422993 · NPPES record last updated Jul 23, 2021
Key facts
- NPI
- 1124422993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 11878522-4810 (UT)
- Practice address
- 7321 Balmer St BLDG 570
Hill Afb, UT 84056-5012 - Phone
- (801) 775-2529
- NPI assigned
- Oct 22, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT640 | NM | MD | Athletic Trainer |
| 003407 | OH | MD | Athletic Trainer |
| 11878522-4810 | UT | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 003407 | OH | |
| Athletic Trainer | 2255A2300X | AT640 | NM | |
| Athletic Trainer | 2255A2300X | 11878522-4810 | UT | Yes |
Addresses
Primary practice location
7321 Balmer St BLDG 570
Hill Afb, UT 84056-5012
Mailing address
3211 South 2580 West
Syracuse, UT 84075
Phone (419) 934-2204
Other practice location 1
126 E County Road 16
Tiffin, OH 44883-8932
Phone (419) 934-2204
Other practice location 2
2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-1111
Other providers in Hill Afb, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.