Individual provider Active NPI

Dane Robert Dorsten, ATC LAT

  • Athletic Trainer
  • Phoenix, AZ
National Provider Identifier
1437663754
Registry record updated Nov 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0944 Issued in AZ
Practice address
444 W Osborn Rd Ste 303
Phoenix, AZ 85013-3820
Phone
(602) 279-8022
Fax
(602) 279-8029
NPI assigned
Nov 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2017

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 0944 AZ Primary

Addresses

Primary practice location

444 W Osborn Rd Ste 303
Phoenix, AZ 85013-3820

Mailing address

444 W Osborn Rd Ste 303
Phoenix, AZ 85013-3820
Phone (602) 279-8022

Other identifiers 2

IdentifierTypeStateIssuer
0944OtherAZARIZONA BOARD OF ATHLETIC TRAINING
60802411OtherBOARD OF CERTIFICATION (ATHLETIC TRAINING(

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
0944AZMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Strength Training Inc PastSince May 1, 2014 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511308800000",
    "number": "1437663754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 W OSBORN RD STE 303",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133820",
            "telephone_number": "602-279-8022",
            "fax_number": "602-279-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 W OSBORN RD STE 303",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133820",
            "telephone_number": "602-279-8022",
            "fax_number": "602-279-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORSTEN",
        "first_name": "DANE",
        "middle_name": "ROBERT",
        "credential": "ATC LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-22",
        "last_updated": "2017-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "0944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA BOARD OF ATHLETIC TRAINING",
            "identifier": "0944",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF CERTIFICATION (ATHLETIC TRAINING(",
            "identifier": "60802411",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; 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.