Active NPI
Benjamin Carbajal, ATC
- Athletic Trainer
- Tucson, AZ
National Provider Identifier
1417985706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0017
- Practice address
- 2202 West Anklam Road
Tucson, AZ 85709-0005 - Phone
- (520) 206-6012
- Fax
- (520) 206-6799
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0017 | AZ | Primary |
Addresses
Primary practice location
2202 West Anklam Road
Tucson, AZ 85709-0005
Mailing address
9311 N Camino de la Tierra
Tucson, AZ 85742-9013
Phone (520) 744-2160
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 |
|---|---|---|---|
| 0017 | AZ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417985706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9311 N CAMINO DE LA TIERRA",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857429013",
"telephone_number": "520-744-2160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2202 WEST ANKLAM ROAD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857090005",
"telephone_number": "520-206-6012",
"fax_number": "520-206-6799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARBAJAL",
"first_name": "BENJAMIN",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AZ",
"license": "0017",
"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.