Active NPI
Joel James Marick, ATC-R
- Athletic Trainer
- Portland, OR
National Provider Identifier
1972630408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-AT-10113264
- Practice address
- 5000 N Willamette Blvd
Portland, OR 97203-5743 - Phone
- (503) 943-7462
- Fax
- (503) 943-7532
- NPI assigned
- Feb 28, 2007
- 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-AT-10113264 | OR | Primary |
Addresses
Primary practice location
5000 N Willamette Blvd
Portland, OR 97203-5743
Mailing address
5211 NE Chateau Dr
Vancouver, WA 98661-2751
Phone (360) 694-1284
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-AT-10113264 | OR | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Portland Health Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Student Health Clinic/Center
- Portland, OR
- NPI 1356545875
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972630408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5211 NE CHATEAU DR",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986612751",
"telephone_number": "360-694-1284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 N WILLAMETTE BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972035743",
"telephone_number": "503-943-7462",
"fax_number": "503-943-7532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARICK",
"first_name": "JOEL",
"middle_name": "JAMES",
"credential": "ATC-R",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OR",
"license": "AT-AT-10113264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
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.