Kirk L Landrum

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT0177 Issued in MS

Practice address

23 Mason St
Laurel, MS 39440-4437

Phone

(601) 399-0547

Fax

(601) 425-7585

NPI assigned

Sep 19, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1003466210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 LANDRUM RD",
            "city": "OVETT",
            "state": "MS",
            "postal_code": "394643735",
            "telephone_number": "601-319-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MASON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404437",
            "telephone_number": "601-399-0547",
            "fax_number": "601-425-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRUM",
        "first_name": "KIRK",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MS",
            "license": "AT0177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "klandrum@scrmc.com",
            "affiliation": "N",
            "address_1": "23 Mason St",
            "city": "Laurel",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394404437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laboratory Corporation of America Holdings
• Peeler Lacey, M.D.
• Seth Ladd, D.O.
• Patrick Lamb, DMD
• Amanda Lucille Landrum-McCallum, C-FNP
• Lori Anne Landrum, PT, DPT
• Christan Dayne Langley
• Christian C. Langley, FNP
• Michael D Larochelle, DO
• Laurel Advanced Medical Equipment LLC

• Athletic Trainer in Laurel, MS
• Providers in Laurel, MS by specialty
• Athletic Trainer in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.