Demetri Eugene Probst

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT007867 Issued in PA

Practice address

248 Susquehanna Ave
Renovo, PA 17764-1523

Phone

(570) 786-7751

NPI assigned

Sep 8, 2020

Last updated

Apr 28, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1366056301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 SUSQUEHANNA AVE",
            "city": "RENOVO",
            "state": "PA",
            "postal_code": "177641523",
            "telephone_number": "570-786-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 SUSQUEHANNA AVE",
            "city": "RENOVO",
            "state": "PA",
            "postal_code": "177641523",
            "telephone_number": "570-786-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROBST",
        "first_name": "DEMETRI",
        "middle_name": "EUGENE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-08",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT007867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Mason
• N Central PA Emergency Physicians, LLC
• PA Rte 120 Inpatient Services, LLC
• Phoenix Rural Home Health of PA
• Probst Family Practice, LLC
• Renovo Fire Department Inc
• Renovo Pharmacy Inc.
• Robert Louis Stehman Jr., RPH
• Brooke Stover, CRNP
• James E. Sweetland, M.D.

• Athletic Trainer in Renovo, PA
• Providers in Renovo, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.