Active NPI
Christopher John Walsh Jr.
- Athletic Trainer
- Moscow, ID
National Provider Identifier
1922529544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-515
- Practice address
- University of Idaho Athletic Training Services
1000 Stadium Way
Moscow, ID 83844-2302 - Phone
- (208) 885-0256
- NPI assigned
- Jul 5, 2017
- 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 | AT-515 | ID | Primary |
Addresses
Primary practice location
University of Idaho Athletic Training Services
1000 Stadium Way
Moscow, ID 83844-2302
Mailing address
University of Idaho Athletics
875 Perimeter Drive Ms 2302
Moscow, ID 83844
Phone (208) 885-0256
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 |
|---|---|---|---|
| AT-515 | ID | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of Idaho | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Moscow, ID
- NPI 1548762867
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499212800000",
"number": "1922529544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "UNIVERSITY OF IDAHO ATHLETICS",
"address_2": "875 PERIMETER DRIVE MS 2302",
"city": "MOSCOW",
"state": "ID",
"postal_code": "83844",
"telephone_number": "208-885-0256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "UNIVERSITY OF IDAHO ATHLETIC TRAINING SERVICES",
"address_2": "1000 STADIUM WAY",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838442302",
"telephone_number": "208-885-0256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "CHRISTOPHER",
"middle_name": "JOHN",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-05",
"last_updated": "2017-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ID",
"license": "AT-515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.