Active NPI
Richard M. O'Connor, MA, ATC, LAT
- Athletic Trainer
- Bristol, TN
National Provider Identifier
1598729048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1002
- Practice address
- 129 Morse Dr
Bristol, TN 37620-8379 - Phone
- (423) 652-4754
- Fax
- (423) 652-6041
- NPI assigned
- Apr 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1002 | TN | Primary |
Addresses
Primary practice location
129 Morse Dr
Bristol, TN 37620-8379
Mailing address
129 Morse Dr
Bristol, TN 37620-8379
Phone (423) 652-4754
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1002 | TN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343088000000",
"number": "1598729048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 MORSE DR",
"city": "BRISTOL",
"state": "TN",
"postal_code": "376208379",
"telephone_number": "423-652-4754",
"fax_number": "423-652-6041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 MORSE DR",
"city": "BRISTOL",
"state": "TN",
"postal_code": "376208379",
"telephone_number": "423-652-4754",
"fax_number": "423-652-6041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "RICHARD",
"middle_name": "M.",
"name_prefix": "Mr.",
"credential": "MA, ATC, LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-13",
"last_updated": "2012-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "1002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristol, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.