Gary Nicholas Rizza, MED, BS.

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0359 Issued in NC

Practice address

110 S Park Ter
Eden, NC 27288-5351

Phone

(336) 627-7778

Fax

(336) 623-1919

NPI assigned

Sep 5, 2007

Last updated

Sep 5, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science, Master of Education

State licenses

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1093909897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S PARK TER",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885351",
            "telephone_number": "336-627-7778",
            "fax_number": "336-623-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S PARK TER",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885351",
            "telephone_number": "336-627-7778",
            "fax_number": "336-623-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZZA",
        "first_name": "GARY",
        "middle_name": "NICHOLAS",
        "credential": "MED, BS.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "0359",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "811355",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Eden, NC
• Providers in Eden, 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 Sep 5, 2007; 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.