Individual provider Active NPI

Duane David Brida, ATC

  • Athletic Trainer
  • Phillipsburg, NJ
National Provider Identifier
1760538458
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
RT000021A Issued in PA
Practice address
200 Hillcrest Blvd
Phillipsburg, NJ 08865-1541
Phone
(908) 213-2497
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 RT000021A PA Primary

Addresses

Primary practice location

200 Hillcrest Blvd
Phillipsburg, NJ 08865-1541

Mailing address

4674 Hampshire Dr
Bethlehem, PA 18017-8450
Phone (610) 837-0828

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
RT000021APAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760538458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4674 HAMPSHIRE DR",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180178450",
            "telephone_number": "610-837-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HILLCREST BLVD",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651541",
            "telephone_number": "908-213-2497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDA",
        "first_name": "DUANE",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT000021A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.