Individual provider Active NPI

Evan Chandra, L.A.T, A.T.C

  • Athletic Trainer
  • Ashland, MA
National Provider Identifier
1386002525
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2771 Issued in MA
Practice address
69 Shore Rd
Ashland, MA 01721-1927
Phone
(508) 361-6318
NPI assigned
Feb 2, 2016
Last updated
Feb 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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 2771 MA Primary

Addresses

Primary practice location

69 Shore Rd
Ashland, MA 01721-1927

Mailing address

69 Shore Rd
Ashland, MA 01721-1927
Phone (508) 361-6318

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

LicenseStateTypeSpecialty
2771MAMDForensic Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1386002525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 SHORE RD",
            "city": "ASHLAND",
            "state": "MA",
            "postal_code": "017211927",
            "telephone_number": "508-361-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 SHORE RD",
            "city": "ASHLAND",
            "state": "MA",
            "postal_code": "017211927",
            "telephone_number": "508-361-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDRA",
        "first_name": "EVAN",
        "credential": "L.A.T, A.T.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-02",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "2771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.