Individual provider Active NPI

Joel E Buffum, MS, ATL, ATC

  • Athletic Trainer
  • Yakima, WA
National Provider Identifier
1396081923
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
A160185522 Issued in WA
Practice address
1470 N 16TH Ave
Yakima, WA 98902-1381
Phone
(509) 941-5746
NPI assigned
Jan 1, 2013
Last updated
Feb 25, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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 A160185522 WA Primary

Addresses

Primary practice location

1470 N 16TH Ave
Yakima, WA 98902-1381

Mailing address

1470 N 16TH Ave
Yakima, WA 98902-1381
Phone (509) 941-5746

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
A160185522WAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1356998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1396081923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 N 16TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989021381",
            "telephone_number": "509-941-5746",
            "fax_number": "509-574-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 N 16TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989021381",
            "telephone_number": "509-941-5746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFFUM",
        "first_name": "JOEL",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "MS, ATL, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-01",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A160185522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.