Adam James Joseph Depew, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2905 Issued in AL

Practice address

301 Sparkman Dr NW
Huntsville, AL 35805-1911

Phone

(256) 824-1000

NPI assigned

Oct 24, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Alabama in Huntsville

  • Primary Care Clinic/Center
  • Huntsville, AL
  • NPI 1144961293
  NPD (past)

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1225755960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 PENNSYLVANIA AVE",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357586271",
            "telephone_number": "256-656-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SPARKMAN DR NW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358051911",
            "telephone_number": "256-824-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPEW",
        "first_name": "ADAM",
        "middle_name": "JAMES JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-24",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AL",
            "license": "2905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajd0054@uah.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "208 Pennsylvania Ave",
            "city": "Madison",
            "state": "AL",
            "country_code": "US",
            "postal_code": "357586271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Department of Veteran Affairs
• Christopher Depew
• Donald Joseph Derivaux, MD
• Rachel Derivaux, MSW
• Dermatology Associates PA
• John Webster Deshazo Sr., D.M.D.

• Athletic Trainer in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Athletic Trainer in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.