Individual provider Active NPI

Paul Brice Tilmon, ATC

  • Athletic Trainer
  • Breaux Bridge, LA
National Provider Identifier
1265405872
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
J00305 Issued in LA
Practice address
1046 Robert LN
Breaux Bridge, LA 70517-7604
Phone
(337) 507-3940
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X J00305 LA Primary

Addresses

Primary practice location

1046 Robert LN
Breaux Bridge, LA 70517-7604

Mailing address

1046 Robert LN
Breaux Bridge, LA 70517-7604
Phone (337) 507-3940

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
J00305LAMDAthletic 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": "1783900800000",
    "number": "1265405872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 ROBERT LN",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705177604",
            "telephone_number": "337-507-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 ROBERT LN",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705177604",
            "telephone_number": "337-507-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILMON",
        "first_name": "PAUL",
        "middle_name": "BRICE",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "LA",
            "license": "J00305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Breaux Bridge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.