Evan Daniel Bader, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT006256 Issued in OH

Practice address

715 Richland Mall
Ontario, OH 44906-3802

Phone

(567) 307-7557

NPI assigned

Jul 8, 2024

Last updated

Dec 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crestview Local School District

  • Local Education Agency (LEA)
  • Ashland, OH
  • NPI 1093924854
  NPD (past)

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1407692494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 STATE ROUTE 96",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448059262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 RICHLAND MALL",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449063802",
            "telephone_number": "567-307-7557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1575 State Route 96",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "OH",
            "postal_code": "448059262",
            "country_code": "US",
            "telephone_number": "419-895-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BADER",
        "first_name": "EVAN",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT006256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Avita Ontario Hospital
• Aubrey-Leigh Reney Baker, NP
• Julie Ball
• Harold A Ballitch II, MD
• Michael Barat, MD
• Courtney Barnett, O.T.

• Athletic Trainer in Ontario, OH
• Providers in Ontario, OH by specialty
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.