Active NPI
Justin F Kokoskie, ATC
- Student Health Clinic/Center
- Tucson, AZ
National Provider Identifier
1386710077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student Health Clinic/Center
- License
- 0245
- Practice address
- 1 National Championship Drive, N108
The University of Arizona
Tucson, AZ 85721-0096 - Phone
- (520) 621-4568
- Fax
- (520) 621-8771
- NPI assigned
- Nov 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student Health Clinic/Center | 261QS1000X | 0245 | AZ | Primary |
Addresses
Primary practice location
1 National Championship Drive, N108
The University of Arizona
Tucson, AZ 85721-0096
Mailing address
9241 E Desert Cove Cir
Tucson, AZ 85730-1359
Phone (520) 519-6944
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 |
|---|---|---|---|
| 0245 | AZ | MD | Student Health Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386710077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9241 E DESERT COVE CIR",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857301359",
"telephone_number": "520-519-6944",
"fax_number": "520-621-8771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 NATIONAL CHAMPIONSHIP DRIVE, N108",
"address_2": "THE UNIVERSITY OF ARIZONA",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857210096",
"telephone_number": "520-621-4568",
"fax_number": "520-621-8771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOKOSKIE",
"first_name": "JUSTIN",
"middle_name": "F",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "261QS1000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Student Health",
"state": "AZ",
"license": "0245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.