Individual provider Active NPI

Laura Beveridge, ATC

  • Athletic Trainer
  • Forest Hill, MD
National Provider Identifier
1215328018
Registry record updated Feb 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
A0000619 Issued in MD
Practice address
339 Streett Cir
Forest Hill, MD 21050-3070
Phone
(443) 617-3205
NPI assigned
Feb 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X A0000619 MD Primary
Athletic Trainer 2255A2300X J3-0000548 DE

Addresses

Primary practice location

339 Streett Cir
Forest Hill, MD 21050-3070

Mailing address

339 Streett Cir
Forest Hill, MD 21050-3070
Phone (443) 617-3205

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

LicenseStateTypeSpecialty
J3-0000548DEMDAthletic Trainer
A0000619MDMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1423958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423958400000",
    "number": "1215328018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 STREETT CIR",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210503070",
            "telephone_number": "443-617-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 STREETT CIR",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210503070",
            "telephone_number": "443-617-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVERIDGE",
        "first_name": "LAURA",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-15",
        "last_updated": "2015-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0000619",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "DE",
            "license": "J3-0000548",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2015; 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.