Ryan Petrossi, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

ATH.312914 Issued in LA

Practice address

11959 Nicholson Dr Apt 17304
Baton Rouge, LA 70810-7626

Phone

(225) 578-9244

NPI assigned

Sep 17, 2020

Last updated

Sep 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1770199531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11959 NICHOLSON DR APT 17304",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11959 NICHOLSON DR APT 17304",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107626",
            "telephone_number": "225-578-9244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSSI",
        "first_name": "RYAN",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "LA",
            "license": "ATH.312914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca E Peters, NP
• Stanley E. Peters, M.D.
• William Ryan Peters, D.D.S.
• Brian Petit, MD
• Cameron Petite
• Samantha Petruccelli
• Colyn Petry, DPT
• Clinton Gary Pettigrew, PHD
• Fred Harper Petty, MD
• Cheryl Karen Peyton, LCSW

• Athletic Trainer in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Athletic Trainer in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.