Individual provider Active NPI

Steven Outlaw

  • Athletic Trainer
  • Orlando, FL
National Provider Identifier
1396399846
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL3913 Issued in FL
Practice address
216 Spencer St
Orlando, FL 32839
Phone
(904) 612-8406
NPI assigned
Aug 1, 2019
Last updated
Aug 1, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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 AL3913 FL Primary

Addresses

Primary practice location

216 Spencer St
Orlando, FL 32839

Mailing address

216 Spencer St
Orlando, FL 32839
Phone (904) 612-8406

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
AL3913FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1396399846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 SPENCER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32839",
            "telephone_number": "904-612-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 SPENCER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32839",
            "telephone_number": "904-612-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "STEVEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-01",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL3913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.