Active NPI
Amanda McBride, MS, ATC
- Athletic Trainer
- Hattiesburg, MS
National Provider Identifier
1154838183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- BOC139800
- Practice address
- 25 Dunleith CT
Hattiesburg, MS 39402-8866 - Phone
- (662) 719-8400
- NPI assigned
- Dec 29, 2017
- Sex
- Female
- 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 | BOC139800 | MS | Primary |
Addresses
Primary practice location
25 Dunleith CT
Hattiesburg, MS 39402-8866
Mailing address
25 Dunleith CT
Hattiesburg, MS 39402-8866
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 |
|---|---|---|---|
| BOC139800 | MS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514505600000",
"number": "1154838183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 DUNLEITH CT",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394028866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 DUNLEITH CT",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394028866",
"telephone_number": "662-719-8400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCBRIDE",
"first_name": "AMANDA",
"credential": "MS, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-29",
"last_updated": "2017-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MS",
"license": "BOC139800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.