Brent Irvin Smith, DHSC, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT003527 Issued in PA

Practice address

146D Recreation Hall
The Pennsylvania State University
University Park, PA 16802-6501

Phone

(814) 865-8816

Fax

(814) 865-7936

NPI assigned

Mar 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1154450617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146D RECREATION HALL",
            "address_2": "THE PENNSYLVANIA STATE UNIVERSITY",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "168026501",
            "telephone_number": "814-865-8816",
            "fax_number": "814-865-7936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146D RECREATION HALL",
            "address_2": "THE PENNSYLVANIA STATE UNIVERSITY",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "168026501",
            "telephone_number": "814-865-8816",
            "fax_number": "814-865-7936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRENT",
        "middle_name": "IRVIN",
        "name_prefix": "Dr.",
        "credential": "DHSC, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT003527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arizona Shreck
• Kimberly Shuey, LPN
• Paula Andrea Siaca Meza
• Rebecca Barbara Simcik, D.O.
• Deborah E. Simoncek, PT, ECS
• Diane Smith, RN
• Vanessa Concordia Smith, CCC-SLP
• Terri Smoyer, LPN
• Ruth Snyder, RN
• Wesley Sohns, ATC

• Athletic Trainer in University Park, PA
• Providers in University Park, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.