Individual provider Active NPI

Shinya Sakurai, ATC

  • Athletic Trainer
  • San Marcos, TX
National Provider Identifier
1215472121
Registry record updated Dec 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2000021063
Practice address
200 Robbie LN Apt 202
San Marcos, TX 78666-6537
Phone
(949) 677-6254
NPI assigned
Dec 31, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2000021063 Primary
Athletic Trainer 2255A2300X AT6305 TX

Addresses

Primary practice location

200 Robbie LN Apt 202
San Marcos, TX 78666-6537

Mailing address

200 Robbie LN Apt 202
San Marcos, TX 78666-6537
Phone (949) 677-6254

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

LicenseStateTypeSpecialty
AT6305TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1483142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483142400000",
    "number": "1215472121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ROBBIE LN APT 202",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666537",
            "telephone_number": "949-677-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ROBBIE LN APT 202",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666537",
            "telephone_number": "949-677-6254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKURAI",
        "first_name": "SHINYA",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-31",
        "last_updated": "2016-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": "2000021063",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT6305",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.

Verify at the official NPI Registry.