Active NPI
Joshua Michael Pahl, AT
- Athletic Trainer
- Grand Rapids, MI
National Provider Identifier
1194098574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2601000741
- Practice address
- 561 Saint Clair Ave NW
Grand Rapids, MI 49534-3418 - Phone
- (616) 550-5521
- NPI assigned
- Feb 16, 2012
- 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 | 2601000741 | MI | Primary |
Addresses
Primary practice location
561 Saint Clair Ave NW
Grand Rapids, MI 49534-3418
Mailing address
561 Saint Clair Ave NW
Grand Rapids, MI 49534-3418
Phone (616) 550-5521
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 |
|---|---|---|---|
| 2601000741 | MI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329350400000",
"number": "1194098574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "561 SAINT CLAIR AVE NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495343418",
"telephone_number": "616-550-5521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "561 SAINT CLAIR AVE NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495343418",
"telephone_number": "616-550-5521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAHL",
"first_name": "JOSHUA",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "AT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-16",
"last_updated": "2012-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": "2601000741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.