Individual provider Active NPI

Nathan Charles Blue, AT

  • Athletic Trainer
  • Pepper Pike, OH
National Provider Identifier
1144720756
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT.003369 Issued in OH
Practice address
32000 Chagrin Blvd
Pepper Pike, OH 44124-5922
Phone
(216) 831-8600
NPI assigned
Feb 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT.003369 OH Primary

Addresses

Primary practice location

32000 Chagrin Blvd
Pepper Pike, OH 44124-5922

Mailing address

5156 Thornbury Rd
Lyndhurst, OH 44124-1255
Phone (440) 858-7745

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

LicenseStateTypeSpecialty
AT.003369OHMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1144720756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5156 THORNBURY RD",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441241255",
            "telephone_number": "440-858-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32000 CHAGRIN BLVD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245922",
            "telephone_number": "216-831-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "NATHAN",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "AT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT.003369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pepper Pike, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.