Individual provider Active NPI

Stephen Brant Parker, ATC, LAT, MA

  • Athletic Trainer
  • Richardson, TX
National Provider Identifier
1215069091
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT0355 Issued in TX
Practice address
6 Gettysburg LN
Richardson, TX 75080-2301
Phone
(972) 437-5995
Fax
(972) 437-5995
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT0355 TX Primary

Addresses

Primary practice location

6 Gettysburg LN
Richardson, TX 75080-2301

Mailing address

6 Gettysburg LN
Richardson, TX 75080-2301
Phone (972) 437-5995

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
AT0355TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215069091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 GETTYSBURG LN",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802301",
            "telephone_number": "972-437-5995",
            "fax_number": "972-437-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 GETTYSBURG LN",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802301",
            "telephone_number": "972-437-5995",
            "fax_number": "972-437-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "STEPHEN",
        "middle_name": "BRANT",
        "name_prefix": "Mr.",
        "credential": "ATC, LAT, MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT0355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.