BRYAN BLACK MAT, LAT, ATC, CKTP
NPI 1407358377
Specialist/Technologist - Athletic Trainer in Fort Wayne, IN

Q: What is Bryan Black's NPI number?

The NPI number for Bryan Black is 1407358377. It was assigned to this individual provider in the NPPES registry on March 6, 2018.

Q: What is Bryan Black's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Bryan Black was last updated on March 6, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since March 06, 2018

3946 ICE WAY FORT WAYNE, FORT WAYNE, IN 46808(517) 425-4996 Get Directions Write a Review

NPPES record last updated: March 6, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Bryan Black Mat, Lat, Atc, Cktp NPPES

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

BRYAN BLACK MAT, LAT, ATC, CKTP (NPI 1407358377) is an individual athletic trainer provider in Fort Wayne, Indiana, licensed in Indiana (36002703A) and active in the NPI registry since March 2018.

NPPES Registry Identity

NPI1407358377

Entity TypeIndividualMale

Primary Taxonomy2255A2300X

Provider Legal NameBRYAN BLACKCredential: MAT, LAT, ATC, CKTP

Location Address3946 ICE WAY FORT WAYNEFort Wayne, IN 46808

Mailing Address3946 Ice Way Fort WayneFort Wayne, IN 46808 · (517) 425-4996

Phone(517) 425-4996

Sole ProprietorNo

Enumeration DateMarch 6, 2018

✔ NPI 1407358377 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 IN · 36002703A

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.

3946 ICE WAY FORT WAYNE, Fort Wayne, IN 46808

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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 Bryan Black's NPI number?

The NPI number for Bryan Black is 1407358377. It was assigned to this individual provider in the NPPES registry on March 6, 2018.

Where is Bryan Black located?

Bryan Black practices at 3946 Ice Way Fort Wayne, Fort Wayne, IN 46808. The listed phone number is (517) 425-4996.

What is Bryan Black'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 Bryan Black was last updated on March 6, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.