Active NPI
Brian Morin, PTA, ATC
- Athletic Trainer
- Standish, ME
National Provider Identifier
1689784282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 111 Ossipee TRL E
Suite 1151
Standish, ME 04084-6464 - Phone
- (207) 642-5325
- Fax
- (207) 642-5395
- NPI assigned
- Aug 30, 2006
- 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 | Primary | ||
| Physical Therapy Assistant | 225200000X | PA3126 | ME |
Addresses
Primary practice location
111 Ossipee TRL E
Suite 1151
Standish, ME 04084-6464
Mailing address
95 Buck St
Gorham, ME 04038-2201
Phone (207) 650-2591
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AT211 | Other | ME | LICENSE # |
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 |
|---|---|---|---|
| PA3126 | ME | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214352000000",
"number": "1689784282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 BUCK ST",
"city": "GORHAM",
"state": "ME",
"postal_code": "040382201",
"telephone_number": "207-650-2591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 OSSIPEE TRL E",
"address_2": "SUITE 1151",
"city": "STANDISH",
"state": "ME",
"postal_code": "040846464",
"telephone_number": "207-642-5325",
"fax_number": "207-642-5395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORIN",
"first_name": "BRIAN",
"credential": "PTA, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2008-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "ME",
"license": "PA3126",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "AT211",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Standish, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.