NPIMap

Individual provider Active NPI

Courtney Phillips, ATC

  • Athletic Trainer
  • The Dalles, OR
National Provider Identifier
1801338066
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT-AT-10145402 Issued in OR
Practice address
551 Lone Pine Blvd
Suite 302
The Dalles, OR 97058-9403
Phone
(541) 506-6500
Fax
(540) 506-6501
NPI assigned
Nov 4, 2016
Last updated
Nov 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT-AT-10145402 OR Primary
Athletic Trainer 2255A2300X A160512820 WA

Addresses

Primary practice location

551 Lone Pine Blvd
Suite 302
The Dalles, OR 97058-9403

Mailing address

551 Lone Pine Blvd
Suite 302
The Dalles, OR 97058-9403
Phone (541) 506-6500

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

LicenseStateTypeSpecialty
AT-AT-10145402ORMDAthletic Trainer
A160512820WAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1801338066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 LONE PINE BLVD",
            "address_2": "SUITE 302",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970589403",
            "telephone_number": "541-506-6500",
            "fax_number": "540-506-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 LONE PINE BLVD",
            "address_2": "SUITE 302",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970589403",
            "telephone_number": "541-506-6500",
            "fax_number": "540-506-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "COURTNEY",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-04",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "AT-AT-10145402",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A160512820",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Dalles, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.

Verify at the official NPI Registry.