Individual provider Active NPI

Robert Jarrod Vanatta, ATC

  • Athletic Trainer
  • Marietta, GA
National Provider Identifier
1851834808
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT002032 Issued in GA
Practice address
1269 Barclay Cir SE
Marietta, GA 30060-2903
Phone
(770) 426-2772
NPI assigned
Nov 23, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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 AT002032 GA Primary

Addresses

Primary practice location

1269 Barclay Cir SE
Marietta, GA 30060-2903

Mailing address

1269 Barclay Cir SE
Marietta, GA 30060-2903
Phone (770) 426-2772

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
AT002032GAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1851834808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1269 BARCLAY CIR SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300602903",
            "telephone_number": "770-426-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1269 BARCLAY CIR SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300602903",
            "telephone_number": "770-426-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANATTA",
        "first_name": "ROBERT",
        "middle_name": "JARROD",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-23",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT002032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; 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.