Nathan Ryan Diffin, ATC

Individual provider Active NPI Athletic Trainer · Ayer, MA

NPI 1619485000 · NPPES record last updated Apr 17, 2018

Key facts

NPI
1619485000
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
141 Washington St
Ayer, MA 01432-1245
Phone
(978) 772-8600
NPI assigned
Jan 19, 2018
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Ayer Shirley Regional School District Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

141 Washington St
Ayer, MA 01432-1245

Mailing address

141 Washington St
Ayer, MA 01432-1245

Other practice location 1

141 Washington St
Ayer, MA 01432-1245
Phone (978) 772-8600

Other providers in Ayer, MA

All providers in Ayer, MA · Athletic Trainer in Massachusetts

Sources for this page

Verify at the official NPI Registry.