Individual provider Active NPI

J Brett Massie, EDD, ATC

  • Athletic Trainer
  • Wilmington, OH
National Provider Identifier
1821066945
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT-101 Issued in OH
Practice address
1870 Quaker Way
Wilmington, OH 45177-2499
Phone
(937) 481-2333
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT-101 OH Primary

Addresses

Primary practice location

1870 Quaker Way
Wilmington, OH 45177-2499

Mailing address

2352 Kenlee Dr
Cincinnati, OH 45230-1499
Phone (513) 405-7562

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-101OHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1821066945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2352 KENLEE DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452301499",
            "telephone_number": "513-405-7562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 QUAKER WAY",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772499",
            "telephone_number": "937-481-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSIE",
        "first_name": "J",
        "middle_name": "BRETT",
        "name_prefix": "Mr.",
        "credential": "EDD, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT-101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.