Individual provider Active NPI

Cheryl Hairston, ATC

  • Athletic Trainer
  • Fairfax, VA
National Provider Identifier
1063895480
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126003495 Issued in VA
Practice address
4400 University Dr
Fairfax, VA 22030-4422
Phone
(703) 993-3277
NPI assigned
Jul 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AL4614 FL
Athletic Trainer 2255A2300X 0126003495 VA Primary

Addresses

Primary practice location

4400 University Dr
Fairfax, VA 22030-4422

Mailing address

4400 University Dr
Ms 3A5
Fairfax, VA 22030-4422

Other practice location 1

111 Lake Hollingsworth Dr
Lakeland, FL 33801-5607
Phone (863) 680-4267

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
AL4614FLMDAthletic Trainer
0126003495VAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1063895480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 UNIVERSITY DR",
            "address_2": "MS 3A5",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 UNIVERSITY DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304422",
            "telephone_number": "703-993-3277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Lake Hollingsworth Dr",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338015607",
            "country_code": "US",
            "telephone_number": "863-680-4267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAIRSTON",
        "first_name": "CHERYL",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL4614",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126003495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.

Verify at the official NPI Registry.