Robert Michael Shifrin, MAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

6624 Issued in FL

Practice address

3031 Garrison Rd
Dunedin, FL 34698-9212

Phone

(314) 479-1917

NPI assigned

Jun 6, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1591401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665273600000",
    "number": "1740804582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14211 KINDERHOOK DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172921",
            "telephone_number": "314-479-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 GARRISON RD",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346989212",
            "telephone_number": "314-479-1917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 S National Ave # Prof160",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658970027",
            "country_code": "US",
            "telephone_number": "314-479-1917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIFRIN",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-06",
        "last_updated": "2022-10-09",
        "certification_date": "2022-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "6624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade Amber Sewell, BCBA
• Anantkumar Manubhai Shah, MD
• Adel J Shamseddine, PHARM.D.
• Sheela Sagar
• Rex Alan Shepherd, PTA
• Diana J Sills Bailin, L.C.S.W.
• Janet W. Simon, RD
• Andrew Martin Sinclair, D.C.
• Chanelle N Sipp, LMT
• Gary Wallace Slater III, CSFA

• Athletic Trainer in Dunedin, FL
• Providers in Dunedin, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2022; 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.