Active NPI
James Dudley, A.T.C. LICENSED
- Athletic Trainer
- Durant, OK
National Provider Identifier
1962606293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 414
- Practice address
- 1405 N 4TH Ave
PMB 4166
Durant, OK 74701-3330 - Phone
- (580) 745-3028
- Fax
- (580) 745-7493
- NPI assigned
- Jun 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 414 | OK | Primary |
Addresses
Primary practice location
1405 N 4TH Ave
PMB 4166
Durant, OK 74701-3330
Mailing address
94 Eagle Loop Drive
Durant, OK 74701-0609
Phone (580) 924-2124
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 |
|---|---|---|---|
| 414 | OK | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962606293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 EAGLE LOOP DRIVE",
"city": "DURANT",
"state": "OK",
"postal_code": "747010609",
"telephone_number": "580-924-2124",
"fax_number": "580-745-7493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 N 4TH AVE",
"address_2": "PMB 4166",
"city": "DURANT",
"state": "OK",
"postal_code": "747013330",
"telephone_number": "580-745-3028",
"fax_number": "580-745-7493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDLEY",
"first_name": "JAMES",
"name_prefix": "Mr.",
"credential": "A.T.C. LICENSED",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OK",
"license": "414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durant, OK
Sources for this page
- 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.