Active NPI
Tracey Ann Driscoll, ATC
- Athletic Trainer
- Daleville, VA
National Provider Identifier
1346586963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0126000173
- Practice address
- 1435 Roanoke Rd
Daleville, VA 24083-2913 - Phone
- (540) 992-1261
- Fax
- (540) 992-8381
- NPI assigned
- Dec 31, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0126000173 | VA | Primary |
Addresses
Primary practice location
1435 Roanoke Rd
Daleville, VA 24083-2913
Mailing address
1435 Roanoke Rd
Daleville, VA 24083-2913
Phone (540) 992-1261
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0126000173 | VA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356912000000",
"number": "1346586963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1435 ROANOKE RD",
"city": "DALEVILLE",
"state": "VA",
"postal_code": "240832913",
"telephone_number": "540-992-1261",
"fax_number": "540-992-8381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1435 ROANOKE RD",
"city": "DALEVILLE",
"state": "VA",
"postal_code": "240832913",
"telephone_number": "540-992-1261",
"fax_number": "540-992-8381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRISCOLL",
"first_name": "TRACEY",
"middle_name": "ANN",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-12-31",
"last_updated": "2012-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "VA",
"license": "0126000173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daleville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.