Active NPI
Adrian Rae Tribble, ATC
- Athletic Trainer
- Fort Smith, AR
National Provider Identifier
1295976694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT 435
- Practice address
- 5210 Grand Ave
Fort Smith, AR 72904-7362 - Phone
- (479) 788-7651
- Fax
- (479) 788-7601
- NPI assigned
- Mar 13, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | AT 435 | AR | Primary |
Addresses
Primary practice location
5210 Grand Ave
Fort Smith, AR 72904-7362
Mailing address
6912 Black Gum Cir
Fort Smith, AR 72916-8924
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 |
|---|---|---|---|
| AT 435 | AR | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236902400000",
"number": "1295976694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6912 BLACK GUM CIR",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729168924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5210 GRAND AVE",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729047362",
"telephone_number": "479-788-7651",
"fax_number": "479-788-7601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRIBBLE",
"first_name": "ADRIAN",
"middle_name": "RAE",
"name_prefix": "Ms.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-13",
"last_updated": "2009-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AR",
"license": "AT 435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.