Individual provider Active NPI

Ryan Chupak, ATC

  • Athletic Trainer
  • West Lawn, PA
National Provider Identifier
1316328347
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
2601 Grandview Blvd
West Lawn, PA 19609-1324
Phone
(610) 670-0180
NPI assigned
Jun 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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 Primary

Addresses

Primary practice location

2601 Grandview Blvd
West Lawn, PA 19609-1324

Mailing address

14 Old Bedford Rd
West Middlesex, PA 16159-3516
Phone (724) 685-1496

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

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1316328347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 OLD BEDFORD RD",
            "city": "WEST MIDDLESEX",
            "state": "PA",
            "postal_code": "161593516",
            "telephone_number": "724-685-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 GRANDVIEW BLVD",
            "city": "WEST LAWN",
            "state": "PA",
            "postal_code": "196091324",
            "telephone_number": "610-670-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUPAK",
        "first_name": "RYAN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lawn, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.