Active NPI
Casey Brooks, LAT, ATC
- Athletic Trainer
- Boaz, AL
National Provider Identifier
1124628979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2769
- Practice address
- 220 N Walnut St
Boaz, AL 35957-1650 - Phone
- (256) 899-3430
- NPI assigned
- Oct 30, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2722 | TN | |
| Athletic Trainer | 2255A2300X | 2769 | AL | Primary |
Addresses
Primary practice location
220 N Walnut St
Boaz, AL 35957-1650
Mailing address
600 Pinehurst Dr Apt E
Albertville, AL 35951-7471
Phone (256) 899-3430
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 |
|---|---|---|---|
| 2722 | TN | MD | Mental Health Counselor |
| 2769 | AL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731974400000",
"number": "1124628979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 PINEHURST DR APT E",
"city": "ALBERTVILLE",
"state": "AL",
"postal_code": "359517471",
"telephone_number": "256-899-3430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 N WALNUT ST",
"city": "BOAZ",
"state": "AL",
"postal_code": "359571650",
"telephone_number": "256-899-3430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "CASEY",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-30",
"last_updated": "2024-11-19",
"certification_date": "2024-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "2722",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AL",
"license": "2769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boaz, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.