Active NPI
Benjamin Merritt, ATC
- Athletic Trainer
- Fort Mill, SC
National Provider Identifier
1114954724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 276
- Practice address
- 225 Munn Rd E
Fort Mill, SC 29715-9497 - Phone
- (803) 548-1900
- Fax
- (803) 548-1911
- NPI assigned
- Jun 27, 2006
- 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 | 276 | SC | Primary |
Addresses
Primary practice location
225 Munn Rd E
Fort Mill, SC 29715-9497
Mailing address
1629 Forest Lake Dr
Rock Hill, SC 29732-9612
Phone (803) 487-0011
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 |
|---|---|---|---|
| 276 | SC | MD | Adult Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114954724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1629 FOREST LAKE DR",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297329612",
"telephone_number": "803-487-0011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 MUNN RD E",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297159497",
"telephone_number": "803-548-1900",
"fax_number": "803-548-1911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRITT",
"first_name": "BENJAMIN",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SC",
"license": "276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Mill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.