Top Dog Nutrition & Fitness

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

234140 Issued in FL

Legal business name

TOP DOG NUTRITION & FITNESS

Practice address

4708 Gibson Rd
#105
Ocean Springs, MS 39564-6042

Phone

(228) 872-1749

Fax

(228) 872-1749

NPI assigned

Mar 18, 2011

Organization subpart

No

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

Authorized official

Name

Miss Sheena Joy Myles

Title

Operations Manager/Co-Owner

Phone

(228) 872-1749

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300406400000",
    "number": "1275832149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4708 GIBSON RD",
            "address_2": "#105",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395646042",
            "telephone_number": "228-872-1749",
            "fax_number": "228-872-1749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4708 GIBSON RD",
            "address_2": "#105",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395646042",
            "telephone_number": "228-872-1749",
            "fax_number": "228-872-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOP DOG NUTRITION & FITNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-18",
        "last_updated": "2011-03-18",
        "status": "A",
        "authorized_official_last_name": "MYLES",
        "authorized_official_first_name": "SHEENA",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "OPERATIONS MANAGER/CO-OWNER",
        "authorized_official_telephone_number": "228-872-1749",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "FL",
            "license": "241367",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "234140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Ocean Springs, MS
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; 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.