Individual provider Active NPI

Dylan Troy Clamors, ATC

  • Athletic Trainer
  • Saint Charles, MO
National Provider Identifier
1154842904
Registry record updated Jul 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2000028786 Issued in MO
Practice address
209 S Kingshighway St
Saint Charles, MO 63301-1693
Phone
(636) 949-4819
NPI assigned
Jul 2, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2000028786 MO Primary

Addresses

Primary practice location

209 S Kingshighway St
Saint Charles, MO 63301-1693

Mailing address

903 Jack Rabbit CT
Saint Peters, MO 63376-5921
Phone (636) 352-8421

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

LicenseStateTypeSpecialty
2000028786MOMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498953600000",
    "number": "1154842904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 JACK RABBIT CT",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633765921",
            "telephone_number": "636-352-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 S KINGSHIGHWAY ST",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633011693",
            "telephone_number": "636-949-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAMORS",
        "first_name": "DYLAN",
        "middle_name": "TROY",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-02",
        "last_updated": "2017-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2000028786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.

Verify at the official NPI Registry.