Individual provider Active NPI

Justin F Kokoskie, ATC

  • Student Health Clinic/Center
  • Tucson, AZ
National Provider Identifier
1386710077
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
License
0245 Issued in AZ
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
0245AZMDStudent 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.

Verify at the official NPI Registry.