Individual provider Active NPI

Telia Brown

  • Athletic Trainer
  • Niceville, FL
National Provider Identifier
1609427756
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
1958 Hattie Mae LN
Niceville, FL 32578-3276
Phone
(580) 649-1094
NPI assigned
Sep 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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 Primary

Addresses

Primary practice location

1958 Hattie Mae LN
Niceville, FL 32578-3276

Mailing address

1958 Hattie Mae LN
Niceville, FL 32578-3276
Phone (580) 649-1094

Other practice location 1

504 University Blvd
tuscaloosa, AL 35401-3540
Phone (580) 649-1094

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

NPI Registry JSON

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1609427756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1958 HATTIE MAE LN",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325783276",
            "telephone_number": "580-649-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1958 HATTIE MAE LN",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325783276",
            "telephone_number": "580-649-1094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "504 University Blvd",
            "address_purpose": "LOCATION",
            "city": "tuscaloosa",
            "state": "AL",
            "postal_code": "354013540",
            "country_code": "US",
            "telephone_number": "580-649-1094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-20",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; 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.