Individual provider Active NPI

Corbin Shatto-Craft

  • Athletic Trainer
  • Middletown, OH
National Provider Identifier
1336865625
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
852 Garver Rd
Middletown, OH 45044-8923
Phone
(513) 508-3774
NPI assigned
Oct 18, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Athletic TrainerGroup: 193400000X SINGLE SPECIALTY GROUP 2255A2300X OH Primary

Addresses

Primary practice location

852 Garver Rd
Middletown, OH 45044-8923

Mailing address

852 Garver Rd
Middletown, OH 45044-8923
Phone (513) 508-3774

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": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1336865625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "852 GARVER RD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450448923",
            "telephone_number": "513-508-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852 GARVER RD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450448923",
            "telephone_number": "513-508-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHATTO-CRAFT",
        "first_name": "CORBIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-18",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.