Active NPI
Christopher Allyn Seldomridge, LAT, ATC. PES, CEAS
- Athletic Trainer
- Lebanon, PA
National Provider Identifier
1124185145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0252
- Practice address
- 115 E Evergreen Rd
Lebanon, PA 17042-7505 - Phone
- (717) 272-2033
- Fax
- (717) 389-1880
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 0252 | NH | Primary |
Addresses
Primary practice location
115 E Evergreen Rd
Lebanon, PA 17042-7505
Mailing address
115 E Evergreen Rd
105 E. Evergreen Rd
Lebanon, PA 17042-7505
Phone (717) 272-2033
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 |
|---|---|---|---|
| 0252 | NH | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402790400000",
"number": "1124185145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 E EVERGREEN RD",
"address_2": "105 E. EVERGREEN RD",
"city": "LEBANON",
"state": "PA",
"postal_code": "170427505",
"telephone_number": "717-272-2033",
"fax_number": "717-389-1880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 E EVERGREEN RD",
"city": "LEBANON",
"state": "PA",
"postal_code": "170427505",
"telephone_number": "717-272-2033",
"fax_number": "717-389-1880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELDOMRIDGE",
"first_name": "CHRISTOPHER",
"middle_name": "ALLYN",
"name_prefix": "Mr.",
"credential": "LAT, ATC. PES, CEAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-02",
"last_updated": "2014-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NH",
"license": "0252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.