NPI age
8 years
Enumerated 2017-07-19
● Active
Type 1 · Individual
Octavio Andres Tobar
Tobar is 1 of 24 specialist/technologist providers in Kennesaw and 1 of 1405 in Georgia.
Primary specialty
Specialist/Technologist
Plus 1 subspecialty
Licensed in
GA, FL
2 states
Status
Active
No deactivations on record
Last NPPES update
2018-08-20
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1405 active specialist/technologist providers in Georgia.
NPI age
8 years
≈ at median (9 yr)
State licenses
2 states
Top 95% — 4% of peers are multi-state
Subspecialties
0
13% of peers hold subspecialties
NPI lifetime · 2017 → 2026
2017-07Enumerated in NPPES
2017
2026
Where they practice
Practice location
1950 Barrett Lakes Blvd Nw Apt 1213
Kennesaw, GA 30144
Mailing address
1950 Barrett Lakes Blvd Nw Apt 1213
Kennesaw, GA 301447535
Additional practice locations
1 secondary location on file with NPPES.
Location 2
3300 W Camelback Rd
Phoenix, AZ 850173030
Specialties
-
Specialist/Technologist PrimaryAthletic 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,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | AT003335 | SECRETARY OF STATE |
| 01 (FL) | AL4196 | FLORIDA DEPARTMENT OF HEALTH |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.