Individual provider Active NPI

Garrett Mossbarger, MS, LAT, ATC

  • Athletic Trainer
  • Fort Worth, TX
National Provider Identifier
1619477593
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT5707 Issued in TX
Practice address
3001 Forest Park Blvd
Fort Worth, TX 76110-2828
Phone
(480) 980-8145
NPI assigned
Feb 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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 AT5707 TX Primary

Addresses

Primary practice location

3001 Forest Park Blvd
Fort Worth, TX 76110-2828

Mailing address

4320 Bellaire Dr S Apt 240
Fort Worth, TX 76109-5171
Phone (480) 980-8145

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
AT5707TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1619477593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 BELLAIRE DR S APT 240",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761095171",
            "telephone_number": "480-980-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 FOREST PARK BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761102828",
            "telephone_number": "480-980-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSSBARGER",
        "first_name": "GARRETT",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-16",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT5707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.