Active NPI
Victoria Merritt
- Athletic Trainer
- Statesboro, GA
National Provider Identifier
1023598281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2505
- Practice address
- 1105 Misty CT
Statesboro, GA 30461-7918 - Phone
- (912) 486-0623
- NPI assigned
- Aug 17, 2018
- Last updated
- Aug 3, 2021
- 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 | 2505 | AL | Primary |
Addresses
Primary practice location
1105 Misty CT
Statesboro, GA 30461-7918
Mailing address
1105 Misty CT
Statesboro, GA 30461-7918
Phone (912) 486-0623
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2505 | AL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627948800000",
"number": "1023598281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 MISTY CT",
"city": "STATESBORO",
"state": "GA",
"postal_code": "304617918",
"telephone_number": "912-486-0623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 MISTY CT",
"city": "STATESBORO",
"state": "GA",
"postal_code": "304617918",
"telephone_number": "912-486-0623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRITT",
"first_name": "VICTORIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-17",
"last_updated": "2021-08-03",
"certification_date": "2021-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AL",
"license": "2505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Statesboro, GA
- Medical Diagnostics of Statesboro LLC
- Medical Health Group LLC
- Merian Mendoza, OTR/L
- Kathryn Ward Mentzer, D.M.D.
- Dalysette Merced Reyes, PHARMD
- Jacquelyn Mesenbrink, MPH, CHES
- Metamorphos Transformational Ministries, Inc (Meta Mental Health)
- Metamorphos Transformational Ministries, Inc.
- Kaitlyn Meyers, LAT, ATC
- MH Health Care Services, PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.