Individual provider Active NPI

Randy Tolle, ATC

  • Athletic Trainer
  • Newton, KS
National Provider Identifier
1598975203
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
24-00025 Issued in KS
Practice address
900 W 12TH St
Newton High School
Newton, KS 67114-1451
Phone
(316) 284-6280
Fax
(316) 284-6288
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 24-00025 KS Primary

Addresses

Primary practice location

900 W 12TH St
Newton High School
Newton, KS 67114-1451

Mailing address

1504 Berry Ave
Newton, KS 67114-1415
Phone (316) 283-9411

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
24-00025KSMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598975203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 BERRY AVE",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671141415",
            "telephone_number": "316-283-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W 12TH ST",
            "address_2": "NEWTON HIGH SCHOOL",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671141451",
            "telephone_number": "316-284-6280",
            "fax_number": "316-284-6288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLE",
        "first_name": "RANDY",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "24-00025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.