Individual provider Active NPI

Daniel Preusser, EDS, MSED, ATC, LAT

  • Athletic Trainer
  • Forest, VA
National Provider Identifier
1043447063
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126001047 Issued in VA
Practice address
1104 E Lawn Dr
Apt 302
Forest, VA 24551-2983
Phone
(434) 426-0226
NPI assigned
Jun 17, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0126001047 VA Primary

Addresses

Primary practice location

1104 E Lawn Dr
Apt 302
Forest, VA 24551-2983

Mailing address

1971 University Blvd
Lynchburg, VA 24515-0002
Phone (434) 582-2414

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

LicenseStateTypeSpecialty
0126001047VAMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1043447063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1971 UNIVERSITY BLVD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245150002",
            "telephone_number": "434-582-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 E LAWN DR",
            "address_2": "APT 302",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512983",
            "telephone_number": "434-426-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREUSSER",
        "first_name": "DANIEL",
        "credential": "EDS, MSED, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-17",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126001047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.