Individual provider Active NPI

Christopher Todd Roy, M.ED.,ATC, LAT, CSCS

  • Athletic Trainer
  • Wichita, KS
National Provider Identifier
1962551051
Registry record updated May 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
24-00388 Issued in KS
Practice address
12112 W Kellogg St
Wichita, KS 67235-1100
Phone
(316) 440-1100
Fax
(316) 440-1089
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 24-00388 KS Primary
Athletic Trainer 2255A2300X 060002519 KS

Addresses

Primary practice location

12112 W Kellogg St
Wichita, KS 67235-1100

Mailing address

1017 N Verda St
Wichita, KS 67203-4373
Phone (316) 943-3757

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
060002519KSMDAthletic Trainer
24-00388KSMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400025600000",
    "number": "1962551051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 N VERDA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034373",
            "telephone_number": "316-943-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12112 W KELLOGG ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672351100",
            "telephone_number": "316-440-1100",
            "fax_number": "316-440-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "CHRISTOPHER",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "M.ED.,ATC, LAT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2014-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "24-00388",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "060002519",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; 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.