Active NPI
Brett David Patterson, ATC
- Athletic Trainer
- Kokomo, IN
National Provider Identifier
1811273956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36000620A
- Practice address
- 2312 S Dixon Rd Ste 250
Kokomo, IN 46902-6426 - Phone
- (765) 455-2122
- Fax
- (765) 455-3122
- NPI assigned
- Nov 2, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 36000620A | IN | Primary |
Addresses
Primary practice location
2312 S Dixon Rd Ste 250
Kokomo, IN 46902-6426
Mailing address
2819 Rockford LN
Kokomo, IN 46902-3201
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 |
|---|---|---|---|
| 36000620A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1811273956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2819 ROCKFORD LN",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469023201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2312 S DIXON RD STE 250",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469026426",
"telephone_number": "765-455-2122",
"fax_number": "765-455-3122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "BRETT",
"middle_name": "DAVID",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-02",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36000620A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.