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MR. PETER O'FALLON JR. ATC/LAT
NPI 1104200179
Specialist/Technologist - Athletic Trainer in Destin, FL

Active since July 19, 2015
4421 COMMONS DR E, SUITE-B 108, DESTIN, FL 32541(850) 460-2588 Get Directions Write a Review

NPPES record last updated: July 19, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Peter O'fallon Jr. Atc/lat NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. PETER O'FALLON JR. ATC/LAT (NPI 1104200179) is an individual athletic trainer provider in Destin, Florida, licensed in Florida (AL 4145) and active in the NPI registry since July 2015.

NPPES Registry Identity

NPI1104200179
Entity TypeIndividualMale
Primary Taxonomy2255A2300X
Provider Legal NameMR. PETER O'FALLON JR.Credential: ATC/LAT
Location Address4421 COMMONS DR E, SUITE-B 108Destin, FL 32541-3484
Mailing Address93 Dune Lakes Cir, B106Santa Rosa Beach, FL 32459-8393 · (314) 952-7123
Phone(850) 460-2588
Sole ProprietorYes
Enumeration DateJuly 19, 2015
✔ NPI 1104200179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2255A2300X
License✔ Licensed in FL · AL 4145
Definition
Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
4421 COMMONS DR E, Destin, FL 32541
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TIMOTHY DEEGAN DOUGLASS D.C.
Chiropractor
4421 COMMONS DR E, SUITE B-105
DESTIN, FL 32541
Okaloosa County (850) 650-6789

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peter O'fallon's NPI number?

The NPI number for Peter O'fallon is 1104200179. It was assigned to this individual provider in the NPPES registry on July 19, 2015.

Where is Peter O'fallon located?

Peter O'fallon practices at 4421 Commons Dr E Suite-B 108, Destin, FL 32541. The listed phone number is (850) 460-2588.

What is Peter O'fallon's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

When was this NPI record last updated?

The NPPES record for Peter O'fallon was last updated on July 19, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.