Active NPI
Charles Marshall Mozena, ATC, LAT
- Athletic Trainer
- Norfolk, VA
National Provider Identifier
1679054035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000031468
- Practice address
- 4700 Powhatan Avenue
Norfolk, VA 23529-0001 - Phone
- (757) 683-3384
- NPI assigned
- Aug 23, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 01260030039 | VA | |
| Athletic Trainer | 2255A2300X | 2000031468 | Primary |
Addresses
Primary practice location
4700 Powhatan Avenue
Norfolk, VA 23529-0001
Mailing address
814 46TH St Apt a
Norfolk, VA 23508-2010
Phone (740) 213-4401
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 |
|---|---|---|---|
| 01260030039 | VA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534982400000",
"number": "1679054035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "814 46TH ST APT A",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235082010",
"telephone_number": "740-213-4401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 POWHATAN AVENUE",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235290001",
"telephone_number": "757-683-3384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOZENA",
"first_name": "CHARLES",
"middle_name": "MARSHALL",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-23",
"last_updated": "2018-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "VA",
"license": "01260030039",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": "2000031468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, VA
- Melissa Lynn Moule, RDN
- Adam Moustapha
- Movement Is Medicine Physical Therapy and Sports Performance
- Abigail Katherine Mowers, LCSW
- Kelsey Lynn Mowery, MD
- Jean-Marie Kakubudia Mpoy Kanyinda, MD
- Kimberleigh Marie Mubarak, LPC
- Joseph Robert Muckenthaler, DDS
- Ivan Kenneth Muhlendorf, M.D.
- Kimberly Anne Mulholland, PT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.