John F Banaszak, A.T.C.

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

314 N 9TH St
Mount Vernon, WA 98273-3327

Phone

(360) 428-6100

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962576736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 598",
            "city": "LA CONNER",
            "state": "WA",
            "postal_code": "982570598",
            "telephone_number": "360-466-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 N 9TH ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982733327",
            "telephone_number": "360-428-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANASZAK",
        "first_name": "JOHN",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "A.T.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Athletic Trainer in Washington

• 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.