David Blaine Laherty II

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

411 Shadywood Dr
Allen, TX 75002-1659

Phone

(385) 231-9995

NPI assigned

Nov 20, 2020

Last updated

Nov 20, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1114520061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 SHADYWOOD DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750021659",
            "telephone_number": "385-231-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 SHADYWOOD DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750021659",
            "telephone_number": "385-231-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAHERTY",
        "first_name": "DAVID",
        "middle_name": "BLAINE",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Allen, TX
• Providers in Allen, TX by specialty
• Athletic Trainer in Texas

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