Active NPI
Will Hedderson, LAT, ATC
- Athletic Trainer
- Gainesville, FL
National Provider Identifier
1255717328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL2977
- Practice address
- 3940 SW 20TH Ave Apt 1103
Gainesville, FL 32607-4413 - Phone
- (352) 727-0246
- NPI assigned
- Jul 30, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL2977 | FL | Primary |
Addresses
Primary practice location
3940 SW 20TH Ave Apt 1103
Gainesville, FL 32607-4413
Mailing address
3940 SW 20TH Ave Apt 1103
Gainesville, FL 32607-4413
Phone (352) 727-0246
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
| License | State | Type | Specialty |
|---|---|---|---|
| AL2977 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438214400000",
"number": "1255717328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3940 SW 20TH AVE APT 1103",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326074413",
"telephone_number": "352-727-0246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3940 SW 20TH AVE APT 1103",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326074413",
"telephone_number": "352-727-0246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEDDERSON",
"first_name": "WILL",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-30",
"last_updated": "2015-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL2977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.