Individual provider Active NPI

Taylor Dumas, LATC

  • Athletic Trainer
  • Lynn, MA
National Provider Identifier
1326823626
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
3059 Issued in MA
Practice address
30 Raddin Grove Ave
Lynn, MA 01905-1964
Phone
(781) 913-3915
NPI assigned
Aug 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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 3059 MA Primary

Addresses

Primary practice location

30 Raddin Grove Ave
Lynn, MA 01905-1964

Mailing address

30 Raddin Grove Ave
Lynn, MA 01905-1964
Phone (781) 913-3915

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

LicenseStateTypeSpecialty
3059MAMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1326823626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 RADDIN GROVE AVE",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019051964",
            "telephone_number": "781-913-3915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 RADDIN GROVE AVE",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019051964",
            "telephone_number": "781-913-3915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMAS",
        "first_name": "TAYLOR",
        "credential": "LATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "3059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.