Active NPI
Drazan Vukovic, ATC
- Athletic Trainer
- Reston, VA
National Provider Identifier
1316566102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0126002879
- Practice address
- 1860 Town Center Dr Ste 300
Reston, VA 20190-5900 - Phone
- (571) 354-1260
- NPI assigned
- Apr 11, 2020
- Sex
- Male
- Sole proprietor
- No
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 | 0126002879 | VA | Primary |
Addresses
Primary practice location
1860 Town Center Dr Ste 300
Reston, VA 20190-5900
Mailing address
1860 Town Center Dr Ste 300
Reston, VA 20190-5900
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 |
|---|---|---|---|
| 0126002879 | VA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646438400000",
"number": "1316566102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 TOWN CENTER DR STE 300",
"city": "RESTON",
"state": "VA",
"postal_code": "201905900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1860 TOWN CENTER DR STE 300",
"city": "RESTON",
"state": "VA",
"postal_code": "201905900",
"telephone_number": "571-354-1260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VUKOVIC",
"first_name": "DRAZAN",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-11",
"last_updated": "2022-03-05",
"certification_date": "2022-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "VA",
"license": "0126002879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.