Active NPI
Brian Lydell Coles, ATC
- Athletic Trainer
- Oak City, UT
National Provider Identifier
1790752590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2306941-4810
- Practice address
- 850 Brushwellman Rd
Oak City, UT 84624 - Phone
- (435) 864-6511
- Fax
- (435) 864-0901
- NPI assigned
- Mar 1, 2006
- Last updated
- Apr 27, 2016
- 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 | 2306941-4810 | UT | Primary |
Addresses
Primary practice location
850 Brushwellman Rd
Oak City, UT 84624
Mailing address
850 Brushwellman Rd
Oak City, UT 84624
Phone (435) 864-6511
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2306941-4810 | UT | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461715200000",
"number": "1790752590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 BRUSHWELLMAN RD",
"city": "OAK CITY",
"state": "UT",
"postal_code": "84624",
"telephone_number": "435-864-6511",
"fax_number": "435-864-0901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 BRUSHWELLMAN RD",
"city": "OAK CITY",
"state": "UT",
"postal_code": "84624",
"telephone_number": "435-864-6511",
"fax_number": "435-864-0901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLES",
"first_name": "BRIAN",
"middle_name": "LYDELL",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-01",
"last_updated": "2016-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "UT",
"license": "2306941-4810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.