Individual provider Active NPI

John Linton Dolese III, ATC

  • Athletic Trainer
  • Ama, LA
National Provider Identifier
1689130841
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
305315 Issued in LA
Practice address
306 Ellen St
Ama, LA 70031-2126
Phone
(504) 616-2492
NPI assigned
Feb 13, 2019
Last updated
Feb 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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 305315 LA Primary

Addresses

Primary practice location

306 Ellen St
Ama, LA 70031-2126

Mailing address

306 Ellen St
Ama, LA 70031-2126
Phone (504) 616-2492

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
305315LAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1689130841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 ELLEN ST",
            "city": "AMA",
            "state": "LA",
            "postal_code": "700312126",
            "telephone_number": "504-616-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 ELLEN ST",
            "city": "AMA",
            "state": "LA",
            "postal_code": "700312126",
            "telephone_number": "504-616-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLESE",
        "first_name": "JOHN",
        "middle_name": "LINTON",
        "name_suffix": "III",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-13",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "LA",
            "license": "305315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ama, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; 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.