Brent M. Faure, MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

008 Issued in ID

Practice address

13279 N Moonglow LN
Pocatello, ID 83202-5122

Phone

(208) 237-2971

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• Tri Med

  • Land Ambulance
  • Pocatello, ID
  • NPI 1336214204
  NPD (past) Authorized official

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649295825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13279 MOONGLOW",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832025122",
            "telephone_number": "208-237-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13279 N MOONGLOW LN",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832025122",
            "telephone_number": "208-237-2971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAURE",
        "first_name": "BRENT",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "MS, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ID",
            "license": "008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Focus Mental Health LLC
• Family Pathways Cooperative, Inc.
• Family Practice Group, P.a.
• Family Practice Group, P.a.
• Chandra T Farnham, PT
• Caroline E Faure, ED.D.; ATC
• Wesston Ford Faux, PHARMD
• Douglas Favor, MD
• Fellows Family Dental - Ad LLC
• Richard E. Fellows, D.D.S.

• Athletic Trainer in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Athletic Trainer in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.