Individual provider Active NPI

Donovan Shreve

  • Athletic Trainer
  • San Juan Capistrano, CA
National Provider Identifier
1982265997
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
30596 Steeplechase Dr
San Juan Capistrano, CA 92675-1920
Phone
(949) 500-9843
NPI assigned
Jun 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Primary

Addresses

Primary practice location

30596 Steeplechase Dr
San Juan Capistrano, CA 92675-1920

Mailing address

30596 Steeplechase Dr
San Juan Capistrano, CA 92675-1920
Phone (949) 500-9843

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

NPI Registry JSON

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1982265997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30596 STEEPLECHASE DR",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751920",
            "telephone_number": "949-500-9843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30596 STEEPLECHASE DR",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751920",
            "telephone_number": "949-500-9843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHREVE",
        "first_name": "DONOVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-21",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan Capistrano, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; 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.