Individual provider Active NPI

Korey Shania Bunal, LAT, ATC

  • Athletic Trainer
  • Greensboro, NC
National Provider Identifier
1235776717
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
LAT-4351 Issued in NC
Practice address
815 W Market St
Greensboro, NC 27401-1875
Phone
(336) 272-7102
NPI assigned
Dec 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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 LAT-4351 NC Primary

Addresses

Primary practice location

815 W Market St
Greensboro, NC 27401-1875

Mailing address

7493 Old Floyd Rd
Rome, NY 13440-0422
Phone (315) 725-8279

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
LAT-4351NCMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1235776717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7493 OLD FLOYD RD",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134400422",
            "telephone_number": "315-725-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W MARKET ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011875",
            "telephone_number": "336-272-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNAL",
        "first_name": "KOREY",
        "middle_name": "SHANIA",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-04",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-4351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.