Individual provider Active NPI

Lydia Loree Case, ATC

  • Athletic Trainer
  • Traverse City, MI
National Provider Identifier
1285764159
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
5246 N Royal Dr
Suite B
Traverse City, MI 49684-6984
Phone
(231) 929-0303
Fax
(231) 929-0305
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 Primary

Addresses

Primary practice location

5246 N Royal Dr
Suite B
Traverse City, MI 49684-6984

Mailing address

4691 Voice Rd
Kingsley, MI 49649-9604
Phone (231) 313-1112

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

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285764159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4691 VOICE RD",
            "city": "KINGSLEY",
            "state": "MI",
            "postal_code": "496499604",
            "telephone_number": "231-313-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5246 N ROYAL DR",
            "address_2": "SUITE B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846984",
            "telephone_number": "231-929-0303",
            "fax_number": "231-929-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASE",
        "first_name": "LYDIA",
        "middle_name": "LOREE",
        "name_prefix": "Mrs.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.