Darius Trevon Rich, MAT, LAT, ATC
Individual provider Active NPI Athletic Trainer · Fayette, MO
NPI 1215765672 · NPPES record last updated Aug 2, 2024
Key facts
- NPI
- 1215765672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 2023049011 (MO)
- Practice address
- 411 Central Methodist SQ Ste 1
Fayette, MO 65248-1198 - Phone
- (660) 248-6251
- NPI assigned
- Jul 25, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023049011 | MO | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2023049011 | MO | Yes |
Addresses
Primary practice location
411 Central Methodist SQ Ste 1
Fayette, MO 65248-1198
Mailing address
3601 W Broadway Apt 32101
Columbia, MO 65203-7930
Phone (660) 631-7677
Other providers in Fayette, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.