Active NPI
Trevor Barry
- Independent Duty Medical Technicians
- Dayton, OH
National Provider Identifier
1992490551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Medical Technicians
- Practice address
- 5486 Buckeye St RM 123
Dayton, OH 45433-5411 - Phone
- (702) 576-6625
- NPI assigned
- Apr 10, 2023
- 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 |
|---|---|---|---|---|
| Independent Duty Medical Technicians | 1710I1003X | Primary |
Addresses
Primary practice location
5486 Buckeye St RM 123
Dayton, OH 45433-5411
Mailing address
559 Vincent St., Space Base Delta 1
Peterson Space Force Base, CO 80914-5411
Phone (702) 576-6625
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": "1681084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1992490551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "559 VINCENT ST., SPACE BASE DELTA 1",
"city": "PETERSON SPACE FORCE BASE",
"state": "CO",
"postal_code": "809145411",
"telephone_number": "702-576-6625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5486 BUCKEYE ST RM 123",
"city": "DAYTON",
"state": "OH",
"postal_code": "454335411",
"telephone_number": "702-576-6625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARRY",
"first_name": "TREVOR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-10",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "1710I1003X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Medical Technicians",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.