Individual provider Active NPI

Stacie Flippin

  • Athletic Trainer
  • Sumter, SC
National Provider Identifier
1225487010
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
1916 Issued in SC
Practice address
2006 Columbia Cir
Sumter, SC 29154-6124
Phone
(803) 968-3647
NPI assigned
Jun 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1916 SC Primary

Addresses

Primary practice location

2006 Columbia Cir
Sumter, SC 29154-6124

Mailing address

2006 Columbia Cir
Sumter, SC 29154-6124

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
1916SCMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1225487010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 COLUMBIA CIR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291546124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 COLUMBIA CIR",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291546124",
            "telephone_number": "803-968-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLIPPIN",
        "first_name": "STACIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "1916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.