Individual provider Active NPI

Shelby Baez, MS, LAT, ATC

  • Athletic Trainer
  • Fayetteville, NC
National Provider Identifier
1326588286
Registry record updated Feb 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126002677 Issued in VA
Practice address
717 Brougham Rd
Fayetteville, NC 28311-0305
Phone
(910) 273-1821
NPI assigned
Feb 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2017

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 0126002677 VA Primary

Addresses

Primary practice location

717 Brougham Rd
Fayetteville, NC 28311-0305

Mailing address

717 Brougham Rd
Fayetteville, NC 28311-0305
Phone (910) 273-1821

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0126002677VAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1488067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488067200000",
    "number": "1326588286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 BROUGHAM RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283110305",
            "telephone_number": "910-273-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 BROUGHAM RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283110305",
            "telephone_number": "910-273-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEZ",
        "first_name": "SHELBY",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-26",
        "last_updated": "2017-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126002677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2017; 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.