Individual provider Active NPI

Baylee Rhae Johnson

  • Athletic Trainer
  • Spearfish, SD
National Provider Identifier
1174220545
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
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

Updated by the provider on Feb 15, 2023

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 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

IdentifierTypeStateIssuer
HID174M53590OtherVAATHLETIC 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.

Verify at the official NPI Registry.