Individual provider Active NPI

Chris Gadah, ATC, LAT

  • Athletic Trainer
  • Orlando, FL
National Provider Identifier
1457960312
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL2346 Issued in FL
Practice address
12340 Boggy Creek Rd
Orlando, FL 32824-6902
Phone
(941) 284-4721
NPI assigned
Jul 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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 AL2346 FL Primary

Addresses

Primary practice location

12340 Boggy Creek Rd
Orlando, FL 32824-6902

Mailing address

2202 Pearl Cider St
Orlando, FL 32824-4483
Phone (941) 284-4721

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
AL2346FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1457960312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 PEARL CIDER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328244483",
            "telephone_number": "941-284-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12340 BOGGY CREEK RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328246902",
            "telephone_number": "941-284-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADAH",
        "first_name": "CHRIS",
        "name_prefix": "Mr.",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL2346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.