Individual provider Active NPI

Hideto Nakazato

  • Athletic Trainer
  • Bellingham, WA
National Provider Identifier
1669982690
Registry record updated Oct 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2000027126 Issued in WA
Practice address
4029 Northwest Ave Ste 302
Bellingham, WA 98226-9077
Phone
(360) 734-2277
Fax
(360) 734-2277
NPI assigned
Oct 4, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2017

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 2000027126 WA Primary

Addresses

Primary practice location

4029 Northwest Ave Ste 302
Bellingham, WA 98226-9077

Mailing address

1319 Tweedsmuir CT
Bellingham, WA 98226-6820

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
2000027126WAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Physical Therapy Inc Past Accepting new patients
Excel Physical Therapy Inc. PastSince Jun 27, 2005 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": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1669982690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 TWEEDSMUIR CT",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982266820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4029 NORTHWEST AVE STE 302",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269077",
            "telephone_number": "360-734-2277",
            "fax_number": "360-734-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAZATO",
        "first_name": "HIDETO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "2000027126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.