Brian Ridderus Oudyk, ATC, LAT, CAT(C)

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0506201 Issued in NV

Practice address

980 Kelly Johnson Dr Ste 200
Las Vegas, NV 89119-3768

Phone

(702) 352-0200

NPI assigned

Apr 3, 2017

Last updated

Apr 3, 2017By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1275065674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 SUMMER PALACE WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891444116",
            "telephone_number": "702-265-6058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 KELLY JOHNSON DR STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891193768",
            "telephone_number": "702-352-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUDYK",
        "first_name": "BRIAN",
        "middle_name": "RIDDERUS",
        "name_prefix": "Mr.",
        "credential": "ATC, LAT, CAT(C)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NV",
            "license": "0506201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Fen Ou
• Wilson Ou
• Zhenqing Ou
• Travis Michael Ouelette
• Chamreun Ouk
• Victoire Way Oulatta
• Elizabeth Ouliguian
• Ounce of Prevention Behavior Services LLC

• Athletic Trainer in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Athletic Trainer in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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.