Individual provider Active NPI

Charles Nostrant, ATC,LAT

  • Athletic Trainer
  • Summerton, SC
National Provider Identifier
1043834120
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2374 Issued in SC
Practice address
9253 Alex Harvin Hwy
Summerton, SC 29148-8175
Phone
(734) 645-5387
NPI assigned
Jun 3, 2020
Last updated
Jun 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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 2374 SC Primary

Addresses

Primary practice location

9253 Alex Harvin Hwy
Summerton, SC 29148-8175

Mailing address

1215 Alice Dr
Sumter, SC 29150-1905

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
2374SCMDAmbulatory Women's Health Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1043834120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 ALICE DR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9253 ALEX HARVIN HWY",
            "city": "SUMMERTON",
            "state": "SC",
            "postal_code": "291488175",
            "telephone_number": "734-645-5387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOSTRANT",
        "first_name": "CHARLES",
        "credential": "ATC,LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "2374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.