Active NPI
Colleen Perry, LAT, ATC
- Athletic Trainer
- Odessa, TX
National Provider Identifier
1194385088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT7409
- Practice address
- 4901 E University Blvd
Odessa, TX 79762-8122 - Phone
- (432) 552-2980
- NPI assigned
- Jun 13, 2019
- Sex
- Female
- 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 | AT7409 | TX | Primary |
Addresses
Primary practice location
4901 E University Blvd
Odessa, TX 79762-8122
Mailing address
5075 E 52ND St Apt K203
Odessa, TX 79762-5145
Phone (323) 493-2879
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 |
|---|---|---|---|
| AT7409 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560384000000",
"number": "1194385088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5075 E 52ND ST APT K203",
"city": "ODESSA",
"state": "TX",
"postal_code": "797625145",
"telephone_number": "323-493-2879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4901 E UNIVERSITY BLVD",
"city": "ODESSA",
"state": "TX",
"postal_code": "797628122",
"telephone_number": "432-552-2980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERRY",
"first_name": "COLLEEN",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-13",
"last_updated": "2019-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT7409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Odessa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.