Si'Ara Washington Farris, ATC, LMT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT003870 Issued in GA

Practice address

564 Hillandale Park Dr
Lithonia, GA 30058-8833

Phone

(843) 718-7536

NPI assigned

Sep 22, 2020

Last updated

Sep 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Si'Ara Shalai Washington Former name

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": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1205442472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 HILLANDALE PARK DR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300588833",
            "telephone_number": "843-718-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 HILLANDALE PARK DR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300588833",
            "telephone_number": "843-718-7536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRIS",
        "first_name": "SI'ARA",
        "middle_name": "WASHINGTON",
        "credential": "ATC, LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT003870",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "1418",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "SC",
            "license": "9454",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SI'ARA",
            "last_name": "WASHINGTON",
            "middle_name": "SHALAI",
            "credential": "ATC, LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Services Unlimited, Inc
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• Aleke Yazmine-Abdullah Farley
• Larhonda Farmer, D.C.
• David Lee Farthing, OT
• Tara E Felix, CCC-SLP
• Shambrille U Fennell
• Arthur Fergerson
• Joseph Fernandez

• Athletic Trainer in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.

Verify at the official NPI Registry.