Active NPI
Brian Stephen Nitz, ATC
- Athletic Trainer
- Siloam Springs, AR
National Provider Identifier
1124557350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT385
- Practice address
- 700 N Progress Ave
Siloam Springs, AR 72761-4349 - Phone
- (479) 524-5134
- NPI assigned
- Jun 10, 2017
- 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 | AT385 | AR | Primary |
Addresses
Primary practice location
700 N Progress Ave
Siloam Springs, AR 72761-4349
Mailing address
2203 W Granite St
Siloam Springs, AR 72761-3315
Phone (479) 220-2964
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 885931099 | Other | NATIONAL ATHLETIC TRAINERS ASSOC. BOARD OF CERTIFICATION |
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 |
|---|---|---|---|
| AT385 | AR | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497052800000",
"number": "1124557350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2203 W GRANITE ST",
"city": "SILOAM SPRINGS",
"state": "AR",
"postal_code": "727613315",
"telephone_number": "479-220-2964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 N PROGRESS AVE",
"city": "SILOAM SPRINGS",
"state": "AR",
"postal_code": "727614349",
"telephone_number": "479-524-5134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NITZ",
"first_name": "BRIAN",
"middle_name": "STEPHEN",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-10",
"last_updated": "2017-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AR",
"license": "AT385",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL ATHLETIC TRAINERS ASSOC. BOARD OF CERTIFICATION",
"identifier": "885931099",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Siloam Springs, AR
- New Creation Professional Counseling & Management Services, Inc.
- New Creation Professional Counseling and Management Services, Inc.
- Baylee Newbauer, PTA
- Jonah John Newsom
- James Cody Newton
- Northwest Arkansas Anesthesia Associates
- Northwest Arkansas Renal Dialysis Associates
- Nwa Second Stage Transition
- Kayleigh O'Brien
- Matthew A Ogan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.