Brian Matthew Duclos, ATC, PES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0126002682 Issued in VA

Practice address

204 W Washington St
Lexington, VA 24450-2554

Phone

(540) 458-4836

Fax

(540) 458-8173

NPI assigned

Apr 3, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1215270681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W WASHINGTON ST",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "244502554",
            "telephone_number": "540-458-4836",
            "fax_number": "540-458-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W WASHINGTON ST",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "244502554",
            "telephone_number": "540-458-4836",
            "fax_number": "540-458-8173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "590 Ferrum Mountain Road",
            "address_2": "Hank Norton Center",
            "address_purpose": "LOCATION",
            "city": "Ferrum",
            "state": "VA",
            "postal_code": "240880775",
            "country_code": "US",
            "telephone_number": "540-365-4520",
            "fax_number": "540-365-4221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUCLOS",
        "first_name": "BRIAN",
        "middle_name": "MATTHEW",
        "credential": "ATC, PES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VT",
            "license": "104.0087653",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NH",
            "license": "0597",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126002682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. a. B. Hammond, PC
• Dr. Linda Larsen PC
• DRS. Downey & Devening, PC
• Scott Brian Dubit, M.D.
• Zachary Zuse Dubit, MD
• Dugan Psychotherapy, PLLC
• Jessica Rush Dugan, MA, LPC
• Toan Quang Duong Jr., D.D.S
• Amelia Durst, MAT, LAT, ATC
• Dva Healthcare Renal Care Inc

• Athletic Trainer in Lexington, VA
• Providers in Lexington, VA by specialty
• Athletic Trainer in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.