The Edge Strength & Conditioning Camp LLC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Legal business name

THE EDGE STRENGTH & CONDITIONING CAMP LLC

Doing business as

Camp 357

Practice address

120 George Wilton Dr
Clayton, NC 27520-9205

Phone

(919) 523-8242

NPI assigned

Oct 20, 2009

Last updated

Oct 20, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Omar Sellers, USAW CERTIFIED COACHNPI 1407182850

Title

Athletic Director

Phone

(919) 208-3646

Specialties & licenses 1

Addresses

Other names 1

• Camp 357 Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Omar Sellers, USAW CERTIFIED COACH

  • Athletic Trainer
  • Clayton, NC
  • NPI 1407182850
  NPD (past) Authorized official

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1083940431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41087",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276291087",
            "telephone_number": "919-208-3646",
            "fax_number": "919-740-3237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 GEORGE WILTON DR",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275209205",
            "telephone_number": "919-523-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EDGE STRENGTH & CONDITIONING CAMP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "SELLERS",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "ATHLETIC DIRECTOR",
        "authorized_official_telephone_number": "919-208-3646",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "USAW CERTIFIED COACH"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camp 357",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jouel Taylor
• Sharon Teel
• Heather Thames
• The Bear Enterprise, LLC
• The Bear Enterprise, LLC
• The Enhancement Center, Inc. (The Enhancement Center - Clayton)
• Therapy for Kids
• Pratheeba Thirucenthilvelan, DMD
• Ashley Leah Thomas, PNP
• Edward C Thomas IV

• Athletic Trainer in Clayton, NC
• Providers in Clayton, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.