Elijah Gabriel Baynes-Marsh, MAT, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0136004037 Issued in VA

Practice address

1 Avenue of the Arts
Newport News, VA 23606-3072

Phone

(651) 600-0356

NPI assigned

Dec 8, 2023

Last updated

Dec 8, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1194592204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2713 OAK AVE UNIT 1",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236074225",
            "telephone_number": "651-600-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AVENUE OF THE ARTS",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063072",
            "telephone_number": "651-600-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYNES-MARSH",
        "first_name": "ELIJAH",
        "middle_name": "GABRIEL",
        "name_prefix": "Mr.",
        "credential": "MAT, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-08",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0136004037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Newport News, VA
• Providers in Newport News, VA by specialty
• Athletic Trainer in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.