Individual provider Active NPI

Brian Edward Conway, ATC; LAT

  • Athletic Trainer
  • Fort Worth, TX
National Provider Identifier
1700878196
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0803 Issued in TX
Practice address
800 5TH Ave
Suite 150
Fort Worth, TX 76104-7300
Phone
(817) 810-7504
Fax
(817) 810-7501
NPI assigned
Aug 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 0803 TX Primary

Addresses

Primary practice location

800 5TH Ave
Suite 150
Fort Worth, TX 76104-7300

Mailing address

2105 Edgewood CT
Arlington, TX 76013-5408
Phone (817) 810-7504

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
0803TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1700878196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 EDGEWOOD CT",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760135408",
            "telephone_number": "817-810-7504",
            "fax_number": "817-810-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 5TH AVE",
            "address_2": "SUITE 150",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047300",
            "telephone_number": "817-810-7504",
            "fax_number": "817-810-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "BRIAN",
        "middle_name": "EDWARD",
        "credential": "ATC; LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "0803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.