Robert F Bristol, ATC, LAT, AEMT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000001701 Issued in NY

Practice address

78 Shellbank PL
Rockville Centre, NY 11570-5833

Phone

(516) 319-8570

NPI assigned

Sep 10, 2009

Last updated

Jan 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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.

• Incorporated Village of East Rockaway

  • Land Ambulance
  • East Rockaway, NY
  • NPI 1245092113
  NPD Authorized official

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

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1457684268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 SHELLBANK PL",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705833",
            "telephone_number": "516-319-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 SHELLBANK PL",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705833",
            "telephone_number": "516-319-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTOL",
        "first_name": "ROBERT",
        "middle_name": "F",
        "credential": "ATC, LAT, AEMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-10",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "NY",
            "license": "356641",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "2000001701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Brice
• Caroline Briglio, RPA-C
• Jennifer M Brignati
• Terry Brill
• Michael H Brisman, M.D.
• Emily Wilmshurst Broderick, PMHNP
• Evan Bronchick, DPT
• Lisa Brown-Eisel, LCSW
• Bennett Howard Brown, MD
• Jeffrey A Brown, M.D.

• Athletic Trainer in Rockville Centre, NY
• Providers in Rockville Centre, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.