Active NPI
Carissa Anne O'Brien
- Athletic Trainer
- Johnstown, NY
National Provider Identifier
1750849683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 3 Frasier Ave
Johnstown, NY 12095-3124 - Phone
- (518) 330-6243
- NPI assigned
- Mar 11, 2019
- Sex
- Female
- 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 | Primary |
Addresses
Primary practice location
3 Frasier Ave
Johnstown, NY 12095-3124
Mailing address
3 Frasier Ave
Johnstown, NY 12095-3124
Phone (518) 330-6243
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552262400000",
"number": "1750849683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 FRASIER AVE",
"city": "JOHNSTOWN",
"state": "NY",
"postal_code": "120953124",
"telephone_number": "518-330-6243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 FRASIER AVE",
"city": "JOHNSTOWN",
"state": "NY",
"postal_code": "120953124",
"telephone_number": "518-330-6243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'BRIEN",
"first_name": "CARISSA",
"middle_name": "ANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-11",
"last_updated": "2019-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnstown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.