Ryan Blake Pridemore, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT-2024-0006 Issued in NM

Practice address

5700 Mesa Grande Dr
Las Cruces, NM 88011-6017

Phone

(423) 312-1031

NPI assigned

Jun 27, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1033895602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 BIXLER DR APT 2202",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880125114",
            "telephone_number": "423-312-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 MESA GRANDE DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880116017",
            "telephone_number": "423-312-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDEMORE",
        "first_name": "RYAN",
        "middle_name": "BLAKE",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-27",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NM",
            "license": "AT-2024-0006",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT9424",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mya Marie Preston
• Kara Lynn Price, PT
• Natalie Price, APRN
• Dennis L Prickett, PT
• Michael Pricoli
• Anthony Prieto, DDS
• Gabriela Lizzette Prieto, LCSW
• Jeremy Prieto
• Jesus Gerardo Prieto Jr.
• Samuel Prieto

• Athletic Trainer in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Athletic Trainer in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.