Active NPI
Eugene B Sinclair Jr., ATC
- Athletic Trainer
- Bradenton, FL
National Provider Identifier
1730859109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 6320
- Practice address
- 5650 Bollettieri Blvd
Bradenton, FL 34210-2211 - Phone
- (800) 872-6425
- NPI assigned
- Sep 16, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 6320 | FL | Primary |
Addresses
Primary practice location
5650 Bollettieri Blvd
Bradenton, FL 34210-2211
Mailing address
3978 75TH St W Apt 405
Bradenton, FL 34209-5810
Phone (904) 554-8536
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000042566 | Other | FL | BOARD OF CERTIFICATION |
| 6320 | Other | FL | ATHLETIC TRAINING LINCESURE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | eugene.sinclair@img.com | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| 6320 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631750400000",
"number": "1730859109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3978 75TH ST W APT 405",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342095810",
"telephone_number": "904-554-8536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5650 BOLLETTIERI BLVD",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342102211",
"telephone_number": "800-872-6425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SINCLAIR",
"first_name": "EUGENE",
"middle_name": "B",
"name_suffix": "Jr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-16",
"last_updated": "2021-09-16",
"certification_date": "2021-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "6320",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF CERTIFICATION",
"identifier": "2000042566",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATHLETIC TRAINING LINCESURE",
"identifier": "6320",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "eugene.sinclair@img.com",
"affiliation": "N",
"endpointDescription": "Work email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "eugenesinclairjr@yahoo.com",
"address_1": "5650 Bollettieri Blvd",
"city": "Bradenton",
"state": "FL",
"country_code": "US",
"postal_code": "342102211",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.