Individual provider Active NPI

William Scott Durand, ATC

  • Athletic Trainer
  • Cortland, IL
National Provider Identifier
1982949749
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096001500 Issued in IL
Practice address
319 N Blue Jay St
Cortland, IL 60112-4224
Phone
(815) 540-8299
NPI assigned
Dec 5, 2012
Last updated
Dec 5, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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 096001500 IL Primary

Addresses

Primary practice location

319 N Blue Jay St
Cortland, IL 60112-4224

Mailing address

319 N Blue Jay St
Cortland, IL 60112-4224
Phone (815) 540-8299

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

LicenseStateTypeSpecialty
096001500ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1982949749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 N BLUE JAY ST",
            "city": "CORTLAND",
            "state": "IL",
            "postal_code": "601124224",
            "telephone_number": "815-540-8299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 N BLUE JAY ST",
            "city": "CORTLAND",
            "state": "IL",
            "postal_code": "601124224",
            "telephone_number": "815-540-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURAND",
        "first_name": "WILLIAM",
        "middle_name": "SCOTT",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-05",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096001500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; 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.