John Charles Roberts Jr., MSED, ATC
Individual provider Active NPI Athletic Trainer · Athens, WV
NPI 1609158559 · NPPES record last updated Jul 31, 2014
Key facts
- NPI
- 1609158559
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 0126000376 (VA)
- Practice address
- 1000 Vermillion St
Concord University
Athens, WV 24712-9027 - Phone
- (304) 384-6346
- Fax
- (304) 384-5331
- NPI assigned
- Sep 16, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0126000376 | VA | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of West Virginia Concord University | Athletic Trainer | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0126000376 | VA | Yes |
Addresses
Primary practice location
1000 Vermillion St
Concord University
Athens, WV 24712-9027
Mailing address
PO Box 1000
Concord University
Athens, WV 24712-1000
Phone (304) 384-6346
Other providers in Athens, WV
- Sydney Philpott
- Karley Renee Poff
- Princeton Community Hospital Assn., Inc
- Jolie M Privett
- Brent Alexander Roark
- Imani T Rodgers
- Jennifer Lauren Sicinski
- Jamari Smith
- State of West Virginia Concord University
- Sarah Steele
All providers in Athens, WV · Athletic Trainer in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.