Active NPI
Daniel Takata, ATC
- Athletic Trainer
- Ruston, LA
National Provider Identifier
1801318720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1650 W Alabama Ave
Ruston, LA 71270-3120 - Phone
- (773) 706-4540
- NPI assigned
- Jul 12, 2017
- Last updated
- Jun 10, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Athletic Trainer | 2255A2300X | NU | Primary |
Addresses
Primary practice location
1650 W Alabama Ave
Ruston, LA 71270-3120
Mailing address
5127 N Nordica Ave
Chicago, IL 60656-3605
Phone (773) 706-4540
Other practice location 1
245 Saponi Ln
Unit 4
Charlottesville, VA 22901
Phone (773) 706-4540
Other practice location 2
1 Jets Dr
Florham Park, NJ 07932-1215
Phone (773) 706-4540
Other practice location 3
720 E 4th St
Chattanooga, TN 37403-1925
Phone (773) 706-4540
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": "1499817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749513600000",
"number": "1801318720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5127 N NORDICA AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606563605",
"telephone_number": "773-706-4540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 W ALABAMA AVE",
"city": "RUSTON",
"state": "LA",
"postal_code": "712703120",
"telephone_number": "773-706-4540"
}
],
"practiceLocations": [
{
"address_1": "245 Saponi Ln",
"address_2": "Unit 4",
"address_purpose": "LOCATION",
"city": "Charlottesville",
"state": "VA",
"postal_code": "22901",
"country_code": "US",
"telephone_number": "773-706-4540",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Jets Dr",
"address_purpose": "LOCATION",
"city": "Florham Park",
"state": "NJ",
"postal_code": "079321215",
"country_code": "US",
"telephone_number": "773-706-4540",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "720 E 4th St",
"address_purpose": "LOCATION",
"city": "Chattanooga",
"state": "TN",
"postal_code": "374031925",
"country_code": "US",
"telephone_number": "773-706-4540",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAKATA",
"first_name": "DANIEL",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-12",
"last_updated": "2025-06-10",
"certification_date": "2025-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ruston, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.