Active NPI
David Philbrick, ATC
- Athletic Trainer
- Saint Clair Shores, MI
National Provider Identifier
1972641488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 040302030
- Practice address
- 20952 E 12 Mile Rd
Suite 110
Saint Clair Shores, MI 48081-3200 - Phone
- (586) 498-3519
- Fax
- (586) 498-3510
- NPI assigned
- Feb 5, 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 | 040302030 | MI | Primary |
Addresses
Primary practice location
20952 E 12 Mile Rd
Suite 110
Saint Clair Shores, MI 48081-3200
Mailing address
3540 River Oaks Blvd
Apt. 3311
Rochester Hills, MI 48309-4501
Phone (586) 498-3519
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 |
|---|---|---|---|
| 040302030 | MI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972641488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3540 RIVER OAKS BLVD",
"address_2": "APT. 3311",
"city": "ROCHESTER HILLS",
"state": "MI",
"postal_code": "483094501",
"telephone_number": "586-498-3519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20952 E 12 MILE RD",
"address_2": "SUITE 110",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480813200",
"telephone_number": "586-498-3519",
"fax_number": "586-498-3510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILBRICK",
"first_name": "DAVID",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": "040302030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Clair Shores, MI
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.