Active NPI
Tanner Richberg, MS, CSCS, CEP
- Athletic Trainer
- Ladson, SC
National Provider Identifier
1013663764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1065725
- Practice address
- 9051 Palmetto Commerce Pkwy
Ladson, SC 29456-6705 - Phone
- (843) 695-2205
- NPI assigned
- Feb 22, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1065725 | SC | Primary |
Addresses
Primary practice location
9051 Palmetto Commerce Pkwy
Ladson, SC 29456-6705
Mailing address
214 Graceland Dr
Moncks Corner, SC 29461-2516
Phone (843) 531-2957
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1065725 | SC | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645488000000",
"number": "1013663764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 GRACELAND DR",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294612516",
"telephone_number": "843-531-2957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9051 PALMETTO COMMERCE PKWY",
"city": "LADSON",
"state": "SC",
"postal_code": "294566705",
"telephone_number": "843-695-2205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHBERG",
"first_name": "TANNER",
"credential": "MS, CSCS, CEP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-02-22",
"last_updated": "2022-02-22",
"certification_date": "2022-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SC",
"license": "1065725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ladson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.