Individual provider Active NPI

Isaac Ofori, BS

  • Athletic Trainer
  • Moscow, ID
National Provider Identifier
1205528130
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
875 Perimeter Dr
Moscow, ID 83844-9803
Phone
(208) 885-6111
NPI assigned
May 19, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Athletic Trainer 2255A2300X Primary

Addresses

Primary practice location

875 Perimeter Dr
Moscow, ID 83844-9803

Mailing address

3182 Fitzpatrick Dr
Concord, CA 94519-2118
Phone (925) 334-9076

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
Credentials
Bachelor of Science

NPI Registry JSON

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1205528130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3182 FITZPATRICK DR",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945192118",
            "telephone_number": "925-334-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 PERIMETER DR",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838449803",
            "telephone_number": "208-885-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFORI",
        "first_name": "ISAAC",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-19",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.