Active NPI
Brendan Douglas Carter, MS,LAT, ATC
- Athletic Trainer
- Saint Bonaventure, NY
National Provider Identifier
1730868829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 004931
- Practice address
- 3261 W State Rd
Saint Bonaventure, NY 14778-9800 - Phone
- (570) 484-2781
- NPI assigned
- Jul 14, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | 004931 | NY | Primary |
Addresses
Primary practice location
3261 W State Rd
Saint Bonaventure, NY 14778-9800
Mailing address
963 Riviera Rd
Warminster, PA 18974-4039
Phone (267) 684-9141
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004931 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776211200000",
"number": "1730868829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "963 RIVIERA RD",
"city": "WARMINSTER",
"state": "PA",
"postal_code": "189744039",
"telephone_number": "267-684-9141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3261 W STATE RD",
"city": "SAINT BONAVENTURE",
"state": "NY",
"postal_code": "147789800",
"telephone_number": "570-484-2781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "BRENDAN",
"middle_name": "DOUGLAS",
"credential": "MS,LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-07-14",
"last_updated": "2026-04-15",
"certification_date": "2026-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "004931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Bonaventure, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.