Individual provider Active NPI

Luke Allen Trail, AT

  • Athletic Trainer
  • Columbia, MO
National Provider Identifier
1881153492
Registry record updated Mar 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
A142148001 Issued in MO
Practice address
198 E Stadium Blvd,
Columbia, MO 65203-6520
Phone
(314) 809-5853
NPI assigned
Mar 14, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193400000X SINGLE SPECIALTY GROUP 2255A2300X A142148001 MO Primary

Addresses

Primary practice location

198 E Stadium Blvd,
Columbia, MO 65203-6520

Mailing address

111 E Stewart Rd
Columbia, MO 65203-4203
Phone (314) 809-5853

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
A142148001MOMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1881153492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E STEWART RD",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034203",
            "telephone_number": "314-809-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 E STADIUM BLVD,",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652036520",
            "telephone_number": "314-809-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAIL",
        "first_name": "LUKE",
        "middle_name": "ALLEN",
        "credential": "AT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-14",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "A142148001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; 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.