Active NPI
Reuben Saavedra I, ATC, LAT
- Athletic Trainer
- Palm Bay, FL
National Provider Identifier
1801399498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT002930
- Practice address
- 1701 Hamilton Ave SW
Palm Bay, FL 32908-8122 - Phone
- (312) 984-0854
- NPI assigned
- Mar 9, 2018
- Last updated
- Mar 9, 2018
- 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 | AT002930 | GA | Primary |
Addresses
Primary practice location
1701 Hamilton Ave SW
Palm Bay, FL 32908-8122
Mailing address
1701 Hamilton Ave SW
Palm Bay, FL 32908-8122
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 |
|---|---|---|---|
| AT002930 | GA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520553600000",
"number": "1801399498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 HAMILTON AVE SW",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329088122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 HAMILTON AVE SW",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329088122",
"telephone_number": "312-984-0854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAAVEDRA",
"first_name": "REUBEN",
"name_suffix": "I",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-09",
"last_updated": "2018-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT002930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.