Active NPI
Gilbert Sumang Patnubay, ATC
- Athletic Trainer
- McDonough, GA
National Provider Identifier
1790826121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT000741
- Practice address
- 105 Regency Park Dr
McDonough, GA 30253-6649 - Phone
- (770) 305-7555
- Fax
- (770) 914-4178
- NPI assigned
- Feb 9, 2007
- Last updated
- Jan 2, 2008
- Sex
- Male
- Sole proprietor
- No
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 | AT000741 | GA | Primary |
Addresses
Primary practice location
105 Regency Park Dr
McDonough, GA 30253-6649
Mailing address
105 Regency Park Dr
McDonough, GA 30253-6649
Phone (770) 305-7555
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 |
|---|---|---|---|
| AT000741 | GA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199232000000",
"number": "1790826121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 REGENCY PARK DR",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302536649",
"telephone_number": "770-305-7555",
"fax_number": "770-914-4178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 REGENCY PARK DR",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302536649",
"telephone_number": "770-305-7555",
"fax_number": "770-914-4178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATNUBAY",
"first_name": "GILBERT",
"middle_name": "SUMANG",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-09",
"last_updated": "2008-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT000741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McDonough, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.