Individual provider Active NPI

Cory Ronald Chaker, PERSONAL TRAINER

  • Athletic Trainer
  • Templeton, CA
National Provider Identifier
1669866562
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
T166587 Issued in CA
Practice address
311 Puffin Way
Templeton, CA 93465-9780
Phone
(805) 769-6776
NPI assigned
Mar 27, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 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 T166587 CA Primary

Addresses

Primary practice location

311 Puffin Way
Templeton, CA 93465-9780

Mailing address

311 Puffin Way
Templeton, CA 93465-9780
Phone (805) 769-6776

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
T166587CAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1669866562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PUFFIN WAY",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659780",
            "telephone_number": "805-769-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 PUFFIN WAY",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659780",
            "telephone_number": "805-769-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKER",
        "first_name": "CORY",
        "middle_name": "RONALD",
        "name_prefix": "Mr.",
        "credential": "PERSONAL TRAINER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "T166587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Templeton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.