Active NPI
Maddy Ravenscraft
- Athletic Trainer
- Statesboro, GA
National Provider Identifier
1013740778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 100 Woodland Dr Apt 1024
Statesboro, GA 30458-7796 - Phone
- (770) 508-4904
- NPI assigned
- Aug 20, 2024
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
100 Woodland Dr Apt 1024
Statesboro, GA 30458-7796
Mailing address
100 Woodland Dr Apt 1024
Statesboro, GA 30458-7796
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724112000000",
"number": "1013740778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 WOODLAND DR APT 1024",
"city": "STATESBORO",
"state": "GA",
"postal_code": "304587796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WOODLAND DR APT 1024",
"city": "STATESBORO",
"state": "GA",
"postal_code": "304587796",
"telephone_number": "770-508-4904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAVENSCRAFT",
"first_name": "MADDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-20",
"last_updated": "2024-08-20",
"certification_date": "2024-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Statesboro, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.