Ryan Smith, ATC LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT002763 Issued in GA

Practice address

1601 Maple St
Carrollton, GA 30118-0001

Phone

(678) 839-3968

NPI assigned

Jun 14, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1245680982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 LOVVORN RD APT 503C",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301172618",
            "telephone_number": "251-362-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 MAPLE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301180001",
            "telephone_number": "678-839-3968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RYAN",
        "credential": "ATC LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT002763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa King Smith, LPC
• Makenzie Smith
• Maria A. Smith, NP
• Mary W Smith, HADS
• Rebecca Smith, P.T.
• Sandra Dale Smith
• Stuart Smith, PA-C
• Tayha Genet Smith
• Taylor Ann Smith
• Somatic Physical Therapy LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.