Brian James Oakes, ATC

Key facts

NPI

1801868427

Entity type

Individual (NPI type 1)

Primary specialty

Athletic Trainer 2255A2300X

License

RT0014484A (PA)

Practice address

Decker Gymnasium Stadium Drive
Mansfield University
Mansfield, PA 16917

Phone

(570) 662-4635

NPI assigned

Feb 7, 2006

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 21, 2013.

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1801868427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BARBER RD",
            "city": "COVINGTON",
            "state": "PA",
            "postal_code": "169179600",
            "telephone_number": "570-659-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DECKER GYMNASIUM STADIUM DRIVE",
            "address_2": "MANSFIELD UNIVERSITY",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "16917",
            "telephone_number": "570-662-4635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OAKES",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT0014484A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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