Active NPI
Dylan E Schmick, MAL, LAT, ATC
- Athletic Trainer
- Boise, ID
National Provider Identifier
1194276550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-546
- Practice address
- 1910 University Drive
Boise, ID 83725 - Phone
- (509) 953-1398
- NPI assigned
- Oct 20, 2016
- 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 | AT-546 | ID | Primary |
Addresses
Primary practice location
1910 University Drive
Boise, ID 83725
Mailing address
PO Box 75
Endicott, WA 99125
Phone (509) 953-1398
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AT-546 | Other | ID | IDAHO STATE BOARD OF MEDICINE |
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 |
|---|---|---|---|
| AT-546 | ID | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476921600000",
"number": "1194276550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 75",
"city": "ENDICOTT",
"state": "WA",
"postal_code": "99125",
"telephone_number": "509-953-1398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 UNIVERSITY DRIVE",
"city": "BOISE",
"state": "ID",
"postal_code": "83725",
"telephone_number": "509-953-1398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHMICK",
"first_name": "DYLAN",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "MAL, LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-10-20",
"last_updated": "2016-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ID",
"license": "AT-546",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO STATE BOARD OF MEDICINE",
"identifier": "AT-546",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.