Individual provider Active NPI

Eli Bisnett-Cobb, MS, ATC

  • Athletic Trainer
  • Ashburn, VA
National Provider Identifier
1336583038
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126001525 Issued in VA
Practice address
21300 Redskin Park Dr
Ashburn, VA 20147-6100
Phone
(703) 726-7000
Fax
(703) 726-7192
NPI assigned
Apr 24, 2013
Last updated
Apr 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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 0126001525 VA Primary

Addresses

Primary practice location

21300 Redskin Park Dr
Ashburn, VA 20147-6100

Mailing address

21300 Redskin Park Dr
Ashburn, VA 20147-6100

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0126001525VAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1336583038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21300 REDSKIN PARK DR",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201476100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21300 REDSKIN PARK DR",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201476100",
            "telephone_number": "703-726-7000",
            "fax_number": "703-726-7192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISNETT-COBB",
        "first_name": "ELI",
        "credential": "MS, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-24",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126001525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; 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.