Individual provider Active NPI

Daniel Watson, ATC

  • Athletic Trainer
  • Newark, DE
National Provider Identifier
1760801435
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
J3-0000233 Issued in DE
Practice address
631 S College Ave
Newark, DE 19716-2010
Phone
(302) 831-7228
NPI assigned
Apr 10, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

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 J3-0000233 DE Primary

Addresses

Primary practice location

631 S College Ave
Newark, DE 19716-2010

Mailing address

631 S College Ave
Newark, DE 19716-2010
Phone (302) 831-7228

Other identifiers 1

IdentifierTypeStateIssuer
079502525OtherDENATABOC

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
J3-0000233DEMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1760801435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 S COLLEGE AVE",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197162010",
            "telephone_number": "302-831-7228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S COLLEGE AVE",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197162010",
            "telephone_number": "302-831-7228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "DANIEL",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "DE",
            "license": "J3-0000233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATABOC",
            "identifier": "079502525",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; 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.