Active NPI
Patricia Kelly Bare Grounds, ATC
- Athletic Trainer
- Holly Springs, NC
National Provider Identifier
1194346965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- LAT-2444
- Practice address
- 445 Texanna Way
Holly Springs, NC 27540-7351 - Phone
- (850) 582-2067
- NPI assigned
- May 2, 2020
- Last updated
- May 2, 2020
- 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 | LAT-2444 | NC | Primary |
Addresses
Primary practice location
445 Texanna Way
Holly Springs, NC 27540-7351
Mailing address
445 Texanna Way
Holly Springs, NC 27540-7351
Phone (850) 582-2067
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | dropbox.com | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LAT-2444 | NC | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bare Essentials Sports Medicine Company | Athletic Trainer | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Athletic Trainer
- Holly Springs, NC
- NPI 1326011834
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588377600000",
"number": "1194346965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 TEXANNA WAY",
"city": "HOLLY SPRINGS",
"state": "NC",
"postal_code": "275407351",
"telephone_number": "850-582-2067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 TEXANNA WAY",
"city": "HOLLY SPRINGS",
"state": "NC",
"postal_code": "275407351",
"telephone_number": "850-582-2067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARE GROUNDS",
"first_name": "PATRICIA",
"middle_name": "KELLY",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-02",
"last_updated": "2020-05-02",
"certification_date": "2020-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NC",
"license": "LAT-2444",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "dropbox.com",
"affiliation": "N",
"endpointDescription": "Secure datatbase for health information",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "445 Texanna Way",
"city": "Holly Springs",
"state": "NC",
"country_code": "US",
"postal_code": "275407351",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Holly Springs, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.