Active NPI
Justin Keith Ware, ATC
- Athletic Trainer
- Oxford, MS
National Provider Identifier
1962091835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-0708
- Practice address
- 900 Sisk Avenue Extended Ste C
Oxford, MS 38655-3433 - Phone
- (662) 449-9190
- NPI assigned
- Jan 14, 2021
- 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-0708 | MS | Primary |
Addresses
Primary practice location
900 Sisk Avenue Extended Ste C
Oxford, MS 38655-3433
Mailing address
702 Happy LN
Oxford, MS 38655-9634
Phone (662) 820-0801
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-0708 | MS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610582400000",
"number": "1962091835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 HAPPY LN",
"city": "OXFORD",
"state": "MS",
"postal_code": "386559634",
"telephone_number": "662-820-0801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 SISK AVENUE EXTENDED STE C",
"city": "OXFORD",
"state": "MS",
"postal_code": "386553433",
"telephone_number": "662-449-9190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARE",
"first_name": "JUSTIN",
"middle_name": "KEITH",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-14",
"last_updated": "2021-01-14",
"certification_date": "2021-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MS",
"license": "AT-0708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oxford, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.