Jonathan Rann Nelson-Chavis, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

LAT-3630 Issued in NC

Practice address

3708 Mayfair St
Durham, NC 27707-6226

Phone

(984) 215-4780

NPI assigned

Oct 13, 2020

Sex

Male

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1114525060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5902 TATTERSALL DR APT 25",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277139055",
            "telephone_number": "252-213-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 MAYFAIR ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076226",
            "telephone_number": "984-215-4780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "590 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275996119",
            "country_code": "US",
            "telephone_number": "984-974-0210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON-CHAVIS",
        "first_name": "JONATHAN",
        "middle_name": "RANN",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-13",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-3630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nellie's Adult Care Home
• Joseph Russell Nellis
• Cynthia D. Nelms Covington, LPT
• Taylor Nelp, M.D.
• Derek Andrew Nelsen, M.D.
• Brandon Scott Nelson, FNP-C
• Brian Nelson, M.D.
• Brooke Nelson
• Diana Christine Nelson, PA-C
• Heather Nelson

• Athletic Trainer in Durham, NC
• Providers in Durham, 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 13, 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.