Active NPI
Paul G Rupp, ATC
- Athletic Trainer
- Vienna, VA
National Provider Identifier
1669499091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0126000151
- Practice address
- 2900 Sutton Rd
Vienna, VA 22181-6109 - Phone
- (703) 319-2833
- Fax
- (703) 319-2713
- NPI assigned
- Jul 15, 2006
- 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 | 0126000151 | VA | Primary |
Addresses
Primary practice location
2900 Sutton Rd
Vienna, VA 22181-6109
Mailing address
11044 Granby CT
Reston, VA 20191-5021
Phone (703) 716-5778
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 |
|---|---|---|---|
| 0126000151 | VA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669499091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11044 GRANBY CT",
"city": "RESTON",
"state": "VA",
"postal_code": "201915021",
"telephone_number": "703-716-5778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 SUTTON RD",
"city": "VIENNA",
"state": "VA",
"postal_code": "221816109",
"telephone_number": "703-319-2833",
"fax_number": "703-319-2713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUPP",
"first_name": "PAUL",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "VA",
"license": "0126000151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, VA
- Barry S Rudolph, D.D.S.
- Kratel S Ruiz-Washington, PSY.D.
- Danielle Alexandra Ruiz, MSN, APRN, AGNP-C
- Jessica Ruiz, LCMHC, LPC, NCC
- Chaniece Rumph, PMHNP
- Rxwellness Spine & Health - Tysons McLean LLC
- Rxwellness Spine & Health - Vienna LLC
- Tracy Joan Ryan Kidd, LCSW
- Susanna Ryan, RN
- James Kiyoung Ryee, DDS
Sources for this page
- 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.