Phillip J Adler, PHD, AT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2601000087 Issued in MI

Practice address

1577 Hawthorne LNDG NW
Cleveland, TN 37312-1859

Phone

(616) 283-0701

NPI assigned

Mar 7, 2006

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 4, 2024.

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714780800000",
    "number": "1811964075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1577 HAWTHORNE LNDG NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373121859",
            "telephone_number": "616-283-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1577 HAWTHORNE LNDG NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373121859",
            "telephone_number": "616-283-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADLER",
        "first_name": "PHILLIP",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD, AT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2024-05-04",
        "certification_date": "2024-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601000087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2024; 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.