Active NPI
Shannon Osborne
- Athletic Trainer
- Davie, FL
National Provider Identifier
1912350794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL4152
- Practice address
- 7500 SW 30TH St
Davie, FL 33314-1020 - Phone
- (954) 452-7071
- NPI assigned
- Jul 18, 2016
- Last updated
- Jul 18, 2016
- Sex
- Male
- Sole proprietor
- No
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 | AL4152 | FL | Primary |
Addresses
Primary practice location
7500 SW 30TH St
Davie, FL 33314-1020
Mailing address
2501 SW 71St Ter
Apt 101
Davie, FL 33317-7037
Phone (334) 549-4765
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
| License | State | Type | Specialty |
|---|---|---|---|
| AL4152 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468800000000",
"number": "1912350794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2501 SW 71ST TER",
"address_2": "APT 101",
"city": "DAVIE",
"state": "FL",
"postal_code": "333177037",
"telephone_number": "334-549-4765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7500 SW 30TH ST",
"city": "DAVIE",
"state": "FL",
"postal_code": "333141020",
"telephone_number": "954-452-7071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSBORNE",
"first_name": "SHANNON",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-18",
"last_updated": "2016-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL4152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.