Active NPI
Daniel Kevin Fohey
- Athletic Trainer
- Canton, MO
National Provider Identifier
1770085201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1 College HL
Canton, MO 63435-1257 - Phone
- (573) 288-6000
- NPI assigned
- Feb 28, 2018
- 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 | Primary |
Addresses
Primary practice location
1 College HL
Canton, MO 63435-1257
Mailing address
3101 St. Mary'S Avenue
Hannibal, MO 63401
Phone (573) 822-2995
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| KFVAN3606262 | Other | BLUECROSS BLUESHIELD |
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": "1519776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519776000000",
"number": "1770085201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3101 ST. MARY'S AVENUE",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "63401",
"telephone_number": "573-822-2995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 COLLEGE HL",
"city": "CANTON",
"state": "MO",
"postal_code": "634351257",
"telephone_number": "573-288-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOHEY",
"first_name": "DANIEL",
"middle_name": "KEVIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-02-28",
"last_updated": "2018-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "KFVAN3606262",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Canton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.