Individual provider Active NPI

Eric Bausano, ATC

  • Athletic Trainer
  • Hancock, MI
National Provider Identifier
1609239896
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
L2547236 Issued in MI
Practice address
820 Quincy St
Apt 2
Hancock, MI 49930-1933
Phone
(906) 483-1831
NPI assigned
Apr 4, 2016
Last updated
Apr 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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 L2547236 MI Primary

Addresses

Primary practice location

820 Quincy St
Apt 2
Hancock, MI 49930-1933

Mailing address

820 Quincy St
Apt 2
Hancock, MI 49930-1933
Phone (906) 483-1831

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
L2547236MIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1609239896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 QUINCY ST",
            "address_2": "APT 2",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301933",
            "telephone_number": "906-483-1831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 QUINCY ST",
            "address_2": "APT 2",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301933",
            "telephone_number": "906-483-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUSANO",
        "first_name": "ERIC",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "L2547236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hancock, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.