Active NPI
Baylee Rhae Johnson
- Athletic Trainer
- Spearfish, SD
National Provider Identifier
1174220545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 8109 Luke CT
Spearfish, SD 57783-6344 - Phone
- (760) 885-5952
- NPI assigned
- Feb 15, 2023
- 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 | Primary |
Addresses
Primary practice location
8109 Luke CT
Spearfish, SD 57783-6344
Mailing address
2132 Monument Dr
Virginia Beach, VA 23464-9014
Phone (760) 885-5952
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HID174M53590 | Other | VA | ATHLETIC TRAINER |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676419200000",
"number": "1174220545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2132 MONUMENT DR",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234649014",
"telephone_number": "760-885-5952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8109 LUKE CT",
"city": "SPEARFISH",
"state": "SD",
"postal_code": "577836344",
"telephone_number": "760-885-5952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "BAYLEE",
"middle_name": "RHAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-15",
"last_updated": "2023-02-15",
"certification_date": "2023-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATHLETIC TRAINER",
"identifier": "HID174M53590",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spearfish, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.