Tanner Bos

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

LAT-4887 Issued in NC

Practice address

558 Wade Stewart Road
Buies Creek, NC 27506

Phone

(641) 224-2226

NPI assigned

Oct 12, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1336864354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 S 10TH ST",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275465613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 WADE STEWART ROAD",
            "city": "BUIES CREEK",
            "state": "NC",
            "postal_code": "27506",
            "telephone_number": "641-224-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOS",
        "first_name": "TANNER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-4887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "tbos@campbell.edu",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "558 Wade Stewart Road",
            "city": "Buies Creek",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy L Bauer, LCAS
• Samantha Bell, LCAS-A
• Michele Blegen
• Jessica Lynn Boettcher, PA
• Stephanie B. Bonds
• Kathryn Paige Dickens Brown, PHARM.D.
• Rebecca Joy Brunson-Nsubuga, MFT-A
• Buies Creek Rural Fire Department Inc
• Renee L. Bullard
• Campbell University

• Athletic Trainer in Buies Creek, NC
• Providers in Buies Creek, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.