Ernest Gregory Eugene, MS, LAT, ATC, CES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0126002142 Issued in VA

Practice address

605 Washington St SW
Blacksburg, VA 24061-1064

Phone

(540) 231-4071

Fax

(540) 231-7335

NPI assigned

Aug 18, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516147200000",
    "number": "1447659271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 MAJESTIC DR",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240735077",
            "telephone_number": "301-537-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 WASHINGTON ST SW",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240611064",
            "telephone_number": "540-231-4071",
            "fax_number": "540-231-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUGENE",
        "first_name": "ERNEST",
        "middle_name": "GREGORY",
        "name_prefix": "Mr.",
        "credential": "MS, LAT, ATC, CES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-18",
        "last_updated": "2018-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "1033-39",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126002142",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT.001873",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2018; 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.