Andrew Ditch, M.S., LAT, ATC

Key facts

NPI

1013435809

Entity type

Individual (NPI type 1)

Primary specialty

Athletic Trainer 2255A2300X

Practice address

600 Lydia Dr
Pelion, SC 29123-9812

Phone

(803) 821-2200

NPI assigned

Sep 1, 2017

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Science

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 5, 2025.

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1013435809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 CEDAR FIELD LN",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291701233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 LYDIA DR",
            "city": "PELION",
            "state": "SC",
            "postal_code": "291239812",
            "telephone_number": "803-821-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Macaw Ln",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "SC",
            "postal_code": "290737673",
            "country_code": "US",
            "telephone_number": "803-463-8787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DITCH",
        "first_name": "ANDREW",
        "credential": "M.S., LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-01",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Pelion, SC · Athletic Trainer in South Carolina