Individual provider Active NPI

Ryan Hart, AT

  • Athletic Trainer
  • Evergreen, CO
National Provider Identifier
1518414432
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT.0002409 Issued in CO
Practice address
1243 Hyland Dr
Evergreen, CO 80439-4838
Phone
(678) 982-3721
NPI assigned
Sep 8, 2016
Last updated
Dec 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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 AT.0002409 CO Primary

Addresses

Primary practice location

1243 Hyland Dr
Evergreen, CO 80439-4838

Mailing address

1243 Hyland Dr
Evergreen, CO 80439-4838
Phone (678) 982-3721

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
AT.0002409COMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1518414432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 HYLAND DR",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804394838",
            "telephone_number": "678-982-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 HYLAND DR",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804394838",
            "telephone_number": "678-982-3721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "RYAN",
        "credential": "AT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-08",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CO",
            "license": "AT.0002409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.