Active NPI
Darin Lee Peterson, MA, LAT, ATC
- Athletic Trainer
- Jacksonville, NC
National Provider Identifier
1144757493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- LAT-1084
- Practice address
- G644 Camp Geiger
School of Infantry-East
Jacksonville, NC 28546 - Phone
- (910) 449-0131
- NPI assigned
- May 17, 2017
- Last updated
- May 17, 2017
- 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 | LAT-1084 | NC | Primary |
Addresses
Primary practice location
G644 Camp Geiger
School of Infantry-East
Jacksonville, NC 28546
Mailing address
G644 Camp Geiger
School of Infantry-East
Jacksonville, NC 28546
Phone (910) 449-0131
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAT-1084 | NC | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494979200000",
"number": "1144757493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "G644 CAMP GEIGER",
"address_2": "SCHOOL OF INFANTRY-EAST",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "28546",
"telephone_number": "910-449-0131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "G644 CAMP GEIGER",
"address_2": "SCHOOL OF INFANTRY-EAST",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "28546",
"telephone_number": "910-449-0131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "DARIN",
"middle_name": "LEE",
"credential": "MA, LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-05-17",
"last_updated": "2017-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NC",
"license": "LAT-1084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.