Individual provider Active NPI

Orenthal James Dunbar, MED, ATC, LAT

  • Athletic Trainer
  • Villa Rica, GA
National Provider Identifier
1881914869
Registry record updated Jun 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
100402072 Issued in GA
Practice address
704 Sycamore Dr
Villa Rica, GA 30180-5324
Phone
(706) 231-1333
NPI assigned
Jun 1, 2010
Last updated
Jun 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2010

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 100402072 GA Primary

Addresses

Primary practice location

704 Sycamore Dr
Villa Rica, GA 30180-5324

Mailing address

704 Sycamore Dr
Villa Rica, GA 30180-5324
Phone (706) 231-1333

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 Education

State licenses

LicenseStateTypeSpecialty
100402072GAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275350400000",
    "number": "1881914869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 SYCAMORE DR",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301805324",
            "telephone_number": "706-231-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 SYCAMORE DR",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301805324",
            "telephone_number": "706-231-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNBAR",
        "first_name": "ORENTHAL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "MED, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-01",
        "last_updated": "2010-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "100402072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; 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.