Individual provider Active NPI

Steven Payson, ATC

  • Athletic Trainer
  • Ontario, OR
National Provider Identifier
1649643289
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT-545 Issued in ID
Practice address
650 College Blvd
Ontario, OR 97914-3423
Phone
(541) 881-5882
NPI assigned
Nov 4, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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 AT-545 ID Primary

Addresses

Primary practice location

650 College Blvd
Ontario, OR 97914-3423

Mailing address

4275 S Trailridge Ave
Boise, ID 83716-6633
Phone (208) 761-5918

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
AT-545IDMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1649643289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4275 S TRAILRIDGE AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837166633",
            "telephone_number": "208-761-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 COLLEGE BLVD",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979143423",
            "telephone_number": "541-881-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYSON",
        "first_name": "STEVEN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ID",
            "license": "AT-545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.

Verify at the official NPI Registry.