Individual provider Active NPI

Marcus Ribant, AT, ATC

  • Athletic Trainer
  • Grand Rapids, MI
National Provider Identifier
1619404951
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2601000969 Issued in MI
Practice address
18 Sunset Hills Ave NW
Grand Rapids, MI 49534-5842
Phone
(810) 444-5354
Fax
(810) 444-5354
NPI assigned
May 17, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 2255A2300X 2601000969 MI Primary

Addresses

Primary practice location

18 Sunset Hills Ave NW
Grand Rapids, MI 49534-5842

Mailing address

18 Sunset Hills Ave NW
Grand Rapids, MI 49534-5842
Phone (810) 444-5354

Other practice location 1

25 Conran Dr
Coopersville, MI 49404-1366
Phone (616) 997-6172

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
2601000969MIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1619404951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SUNSET HILLS AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495345842",
            "telephone_number": "810-444-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 SUNSET HILLS AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495345842",
            "telephone_number": "810-444-5354",
            "fax_number": "810-444-5354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Conran Dr",
            "address_purpose": "LOCATION",
            "city": "Coopersville",
            "state": "MI",
            "postal_code": "494041366",
            "country_code": "US",
            "telephone_number": "616-997-6172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIBANT",
        "first_name": "MARCUS",
        "credential": "AT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601000969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.