Active NPI
Dane K Newby, ATC
- Athletic Trainer
- Warner Robins, GA
National Provider Identifier
1073769832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT001497
- Practice address
- 3051 Watson Blvd Ste 400
Warner Robins, GA 31093-8556 - Phone
- (478) 953-7556
- NPI assigned
- Aug 13, 2008
- Sex
- Male
- 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 | AT001497 | GA | Primary |
Addresses
Primary practice location
3051 Watson Blvd Ste 400
Warner Robins, GA 31093-8556
Mailing address
3857 Hamlin Floyd Rd
Jeffersonville, GA 31044-8019
Phone (478) 697-1107
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 |
|---|---|---|---|
| AT001497 | GA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218585600000",
"number": "1073769832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3857 HAMLIN FLOYD RD",
"city": "JEFFERSONVILLE",
"state": "GA",
"postal_code": "310448019",
"telephone_number": "478-697-1107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3051 WATSON BLVD STE 400",
"city": "WARNER ROBINS",
"state": "GA",
"postal_code": "310938556",
"telephone_number": "478-953-7556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWBY",
"first_name": "DANE",
"middle_name": "K",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-13",
"last_updated": "2008-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT001497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warner Robins, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.