Active NPI
Thomas Gerald Blakeslee, ATC, LAT
- Athletic Trainer
- Salt Lake City, UT
National Provider Identifier
1225737869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 12937807-4810
- Practice address
- 1800 Campus Center Dr
Hper West
Salt Lake City, UT 84112 - Phone
- (302) 220-1247
- NPI assigned
- Mar 2, 2023
- Sex
- Male
- Sole proprietor
- No
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 | 12937807-4810 | UT | Primary |
Addresses
Primary practice location
1800 Campus Center Dr
Hper West
Salt Lake City, UT 84112
Mailing address
325 S Orchard Dr Apt D309
North Salt Lake, UT 84054-1873
Phone (302) 220-1247
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 |
|---|---|---|---|
| 12937807-4810 | UT | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677715200000",
"number": "1225737869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 S ORCHARD DR APT D309",
"city": "NORTH SALT LAKE",
"state": "UT",
"postal_code": "840541873",
"telephone_number": "302-220-1247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 CAMPUS CENTER DR",
"address_2": "HPER WEST",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84112",
"telephone_number": "302-220-1247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKESLEE",
"first_name": "THOMAS",
"middle_name": "GERALD",
"name_prefix": "Mr.",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-02",
"last_updated": "2023-03-02",
"certification_date": "2023-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "UT",
"license": "12937807-4810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.