Individual provider Active NPI

Robert Prest, ATC, LAT, EMT-B

  • Athletic Trainer
  • Saint Louis, MO
National Provider Identifier
1831510718
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2009002521 Issued in MO
Practice address
1201 S Warson Rd
Saint Louis, MO 63124-1266
Phone
(314) 993-6447
NPI assigned
Dec 19, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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 2009002521 MO Primary

Addresses

Primary practice location

1201 S Warson Rd
Saint Louis, MO 63124-1266

Mailing address

119 Watson PLZ
Saint Louis, MO 63126-1962

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
2009002521MOMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1831510718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 WATSON PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631261962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S WARSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241266",
            "telephone_number": "314-993-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREST",
        "first_name": "ROBERT",
        "credential": "ATC, LAT, EMT-B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-19",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2009002521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; 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.