NPIMap

Organization Active NPI

Individual

  • Athletic Trainer
  • Orion, MI
National Provider Identifier
1669862587
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Legal business name
INDIVIDUAL
Practice address
2926 Waldon Park Dr
Orion, MI 48359-1336
Phone
(248) 390-8998
NPI assigned
Jan 30, 2015
Last updated
Jan 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Authorized official

Name
Dr. Brian HatzelNPI 1669446704
Title
Associate Professor
Phone
(616) 331-8538

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X NU Primary

Addresses

Primary practice location

2926 Waldon Park Dr
Orion, MI 48359-1336

Mailing address

2926 Waldon Park Dr
Orion, MI 48359-1336

National Provider Directory

National Provider Directory
Tax ID family
Grand Valley State University4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1669862587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2926 WALDON PARK DR",
            "city": "ORION",
            "state": "MI",
            "postal_code": "483591336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2926 WALDON PARK DR",
            "city": "ORION",
            "state": "MI",
            "postal_code": "483591336",
            "telephone_number": "248-390-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-30",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "HATZEL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "ASSOCIATE PROFESSOR",
        "authorized_official_telephone_number": "616-331-8538",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orion, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.