Active NPI
Nicholas J Williams, ATC
- Athletic Trainer
- Park City, UT
National Provider Identifier
1629313465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 8455635-4810
- Practice address
- 900 Round Valley Dr
Suite 100
Park City, UT 84060-7552 - Phone
- (435) 655-6600
- Fax
- (435) 655-2388
- NPI assigned
- Dec 5, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 8455635-4810 | UT | Primary |
Addresses
Primary practice location
900 Round Valley Dr
Suite 100
Park City, UT 84060-7552
Mailing address
900 Round Valley Dr
Suite 100
Park City, UT 84060-7552
Phone (435) 655-6600
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8455635-4810 | UT | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428192000000",
"number": "1629313465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 ROUND VALLEY DR",
"address_2": "SUITE 100",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840607552",
"telephone_number": "435-655-6600",
"fax_number": "435-655-2388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 ROUND VALLEY DR",
"address_2": "SUITE 100",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840607552",
"telephone_number": "435-655-6600",
"fax_number": "435-655-2388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "NICHOLAS",
"middle_name": "J",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-12-05",
"last_updated": "2015-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "UT",
"license": "8455635-4810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.