Scott Michael Buddelmeyer, ATC, EMT-B

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

022051 Issued in OH

Practice address

1400 E 2ND St
Defiance, OH 43512-2440

Phone

(419) 783-2791

NPI assigned

Apr 3, 2006

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912969429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 JOHN ST",
            "city": "HOLGATE",
            "state": "OH",
            "postal_code": "435279806",
            "telephone_number": "419-264-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E 2ND ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122440",
            "telephone_number": "419-783-2791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDDELMEYER",
        "first_name": "SCOTT",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "ATC, EMT-B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "022051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Defiance, OH
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.