Individual provider Active NPI

Liam Chayse Casto, ATC

  • Athletic Trainer
  • Bidwell, OH
National Provider Identifier
1477084374
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT005875 Issued in OH
Practice address
101 Service Rd
Bidwell, OH 45614-8021
Phone
(740) 645-8274
NPI assigned
Mar 22, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2019

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 AT005875 OH Primary

Addresses

Primary practice location

101 Service Rd
Bidwell, OH 45614-8021

Mailing address

101 Service Rd
Bidwell, OH 45614-8021
Phone (740) 645-8274

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
AT005875OHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1477084374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SERVICE RD",
            "city": "BIDWELL",
            "state": "OH",
            "postal_code": "456148021",
            "telephone_number": "740-645-8274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SERVICE RD",
            "city": "BIDWELL",
            "state": "OH",
            "postal_code": "456148021",
            "telephone_number": "740-645-8274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTO",
        "first_name": "LIAM",
        "middle_name": "CHAYSE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-22",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT005875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bidwell, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; 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.