Individual provider Active NPI

Justin Walter Seligman, ATC

  • Athletic Trainer
  • Smithfield, VA
National Provider Identifier
1720415771
Registry record updated Oct 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126001704 Issued in VA
Practice address
14171 Turner Dr
Smithfield, VA 23430-6675
Phone
(540) 454-8124
NPI assigned
Oct 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2013

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 0126001704 VA Primary

Addresses

Primary practice location

14171 Turner Dr
Smithfield, VA 23430-6675

Mailing address

1040 Spotswood Ave Apt 206
Norfolk, VA 23507-1200
Phone (540) 454-8124

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
0126001704VAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1381017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381017600000",
    "number": "1720415771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SPOTSWOOD AVE APT 206",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071200",
            "telephone_number": "540-454-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14171 TURNER DR",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234306675",
            "telephone_number": "540-454-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELIGMAN",
        "first_name": "JUSTIN",
        "middle_name": "WALTER",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-06",
        "last_updated": "2013-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126001704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2013; 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.