Active NPI
Stephen Spencer Deffner, MS, AT
- Athletic Trainer
- Eaton, OH
National Provider Identifier
1831521335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT.003649
- Practice address
- 112 Lutheran Dr
Eaton, OH 45320-1618 - Phone
- (937) 689-1025
- NPI assigned
- Aug 7, 2013
- Sex
- Male
- Sole proprietor
- No
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT.003649 | OH | MD | Athletic Trainer |
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 | AT.003649 | OH | Primary |
Addresses
Primary practice location
112 Lutheran Dr
Eaton, OH 45320-1618
Mailing address
112 Lutheran Dr
Eaton, OH 45320-1618
NPI Registry JSON
{
"created_epoch": "1375833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375833600000",
"number": "1831521335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 LUTHERAN DR",
"city": "EATON",
"state": "OH",
"postal_code": "453201618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 LUTHERAN DR",
"city": "EATON",
"state": "OH",
"postal_code": "453201618",
"telephone_number": "937-689-1025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEFFNER",
"first_name": "STEPHEN",
"middle_name": "SPENCER",
"name_prefix": "Mr.",
"credential": "MS, AT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-07",
"last_updated": "2013-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "AT.003649",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eaton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.