Active NPI
Tara Danielle Peterson, MS, LAT, ATC, CSCS
- Athletic Trainer
- Sylva, NC
National Provider Identifier
1144619107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- LAT-1391
- Practice address
- 896 Ashe Loop Rd
Sylva, NC 28779-8810 - Phone
- (860) 965-3527
- Fax
- (828) 227-7446
- NPI assigned
- Jan 14, 2015
- Sex
- Female
- 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 | LAT-1391 | NC | Primary |
Addresses
Primary practice location
896 Ashe Loop Rd
Sylva, NC 28779-8810
Mailing address
896 Ashe Loop Rd
Sylva, NC 28779-8810
Phone (860) 965-3527
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAT-1391 | NC | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421193600000",
"number": "1144619107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "896 ASHE LOOP RD",
"city": "SYLVA",
"state": "NC",
"postal_code": "287798810",
"telephone_number": "860-965-3527",
"fax_number": "828-227-7446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "896 ASHE LOOP RD",
"city": "SYLVA",
"state": "NC",
"postal_code": "287798810",
"telephone_number": "860-965-3527",
"fax_number": "828-227-7446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "TARA",
"middle_name": "DANIELLE",
"credential": "MS, LAT, ATC, CSCS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-14",
"last_updated": "2015-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NC",
"license": "LAT-1391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sylva, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.