Colton Funk

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

3024 Issued in MN

Practice address

405 Emmet St
Charlottesville, VA 22904

Phone

(715) 490-1835

NPI assigned

Jun 9, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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.

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633132800000",
    "number": "1942659040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 SPRING CREEK RD",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "54501",
            "telephone_number": "715-490-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 EMMET ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22904",
            "telephone_number": "715-490-1835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 Saint Olaf Ave",
            "address_purpose": "LOCATION",
            "city": "Northfield",
            "state": "MN",
            "postal_code": "550571574",
            "country_code": "US",
            "telephone_number": "715-490-1835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNK",
        "first_name": "COLTON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-09",
        "last_updated": "2021-10-02",
        "certification_date": "2021-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "3024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corene S Fuller, PA
• Renee Ann Fuller, OT
• Robert R Fuller, MD
• Fuller'S Orthopedic
• Olivia Fulton, OT
• Joyce Funston, RN IBCLC
• Megan Furey
• Jennifer Furlow, NP
• Joseph Weldon Furr Jr., MD
• Miriam Mae L Furr, MD

• Athletic Trainer in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Athletic Trainer in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2021; 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.