Individual provider Active NPI

Robert W Duncanson, MED, ATC, CSCS

  • Athletic Trainer
  • Knoxville, TN
National Provider Identifier
1235103763
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0000001073 Issued in TN
Practice address
1704 Johnny Majors Dr
RM. 117a, Neyland-Thompson Sports Center
Knoxville, TN 37996-4538
Phone
(865) 974-1359
Fax
(865) 974-1259
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X AL 1441 FL
Athletic Trainer 2255A2300X 0000001073 TN Primary

Addresses

Primary practice location

1704 Johnny Majors Dr
RM. 117a, Neyland-Thompson Sports Center
Knoxville, TN 37996-4538

Mailing address

PO Box 15162
Knoxville, TN 37901-5162
Phone (865) 974-1359

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 Education

State licenses

LicenseStateTypeSpecialty
AL 1441FLMDSpecialist
0000001073TNMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1235103763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15162",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379015162",
            "telephone_number": "865-974-1359",
            "fax_number": "865-974-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 JOHNNY MAJORS DR",
            "address_2": "RM. 117A, NEYLAND-THOMPSON SPORTS CENTER",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379964538",
            "telephone_number": "865-974-1359",
            "fax_number": "865-974-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCANSON",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "MED, ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "AL 1441",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "0000001073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.