Individual provider Active NPI

Sean Doyle

  • Athletic Trainer
  • Bridgewater, NJ
National Provider Identifier
1649673476
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
25MT00186400 Issued in NJ
Practice address
1 Patriots Park
Bridgewater, NJ 08807-3454
Phone
(908) 203-5972
NPI assigned
Oct 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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 25MT00186400 NJ Primary

Addresses

Primary practice location

1 Patriots Park
Bridgewater, NJ 08807-3454

Mailing address

1 Patriots Park
Bridgewater, NJ 08807-3454
Phone (908) 203-5972

Other practice location 1

5035 Route 130
Delran, NJ 08075-1702
Phone (856) 461-5400

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
25MT00186400NJMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Wood Johnson University Hospital Inc PastSince Sep 25, 2019 Accepting new patients
Somerset Medical Center PastSince Sep 25, 2019 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1649673476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PATRIOTS PARK",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088073454",
            "telephone_number": "908-203-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PATRIOTS PARK",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088073454",
            "telephone_number": "908-203-5972"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5035 Route 130",
            "address_purpose": "LOCATION",
            "city": "Delran",
            "state": "NJ",
            "postal_code": "080751702",
            "country_code": "US",
            "telephone_number": "856-461-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "SEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-07",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00186400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.