Nathan C Maynard, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT2259 Issued in KY

Practice address

650 Joel Dr
Fort Campbell, KY 42223-5318

Phone

(573) 233-5911

NPI assigned

Apr 26, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1346695533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 EYSIAN RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370406581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "573-233-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "NATHAN",
        "middle_name": "C",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-26",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "3295",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2019020157",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KY",
            "license": "AT2259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Allen Matzek, M.D.
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• Kevin E. Mayberry, PA-C
• Peggy Ann Mayfield
• Robb Maylor
• Harold E Mazurek, PA-C
• Shellon Angela McAllister-Rogers, MD
• Katherine McCabe, DMD
• Errica McCaleb, MS
• Angela Rose McCalla, OTR/L

• Athletic Trainer in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Athletic Trainer in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; 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.