Individual provider Active NPI

Brian Pashkevich, ATC

  • Athletic Trainer
  • Monroe, LA
National Provider Identifier
1548700503
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
ATH.200432 Issued in LA
Practice address
308 Warhawk Way
Monroe, LA 71209-0001
Phone
(908) 930-1163
NPI assigned
Feb 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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 ATH.200432 LA Primary

Addresses

Primary practice location

308 Warhawk Way
Monroe, LA 71209-0001

Mailing address

308 Warhawk Way
Monroe, LA 71209-0001
Phone (908) 930-1163

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
ATH.200432LAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1548700503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 WARHAWK WAY",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712090001",
            "telephone_number": "908-930-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 WARHAWK WAY",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712090001",
            "telephone_number": "908-930-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASHKEVICH",
        "first_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-24",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "LA",
            "license": "ATH.200432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.