Derek Michael Eggers, PROVIDER CODE 22

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT 002797 Issued in OH

Practice address

7277 Smiths Mill Rd
New Albany, OH 43054-8195

Phone

(614) 440-1577

NPI assigned

Dec 19, 2006

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

Other identifiers 1

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124181227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 GRANADA AVE",
            "city": "GALLOWAY",
            "state": "OH",
            "postal_code": "431199577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7277 SMITHS MILL RD",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430548195",
            "telephone_number": "614-440-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGGERS",
        "first_name": "DEREK",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PROVIDER CODE 22",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT 002797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATC",
            "identifier": "22",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in New Albany, OH
• Providers in New Albany, OH by specialty
• Athletic Trainer in Ohio

• 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.

Verify at the official NPI Registry.