Lauren A Willie, LAT, ATC, MAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT004188 Issued in GA

Practice address

6649 Vibbert Ave
Fort Benning, GA 31905-4464

Phone

(251) 716-2109

NPI assigned

Oct 4, 2022

Sex

Female

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": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1356065270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 LEE ROAD 613",
            "city": "SMITHS STATION",
            "state": "AL",
            "postal_code": "368772004",
            "telephone_number": "251-716-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6649 VIBBERT AVE",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319054464",
            "telephone_number": "251-716-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIE",
        "first_name": "LAUREN",
        "middle_name": "A",
        "credential": "LAT, ATC, MAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT004188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lauren.a.willie.ctr@mail.mil",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "6649 Vibbert Ave",
            "city": "Fort Benning",
            "state": "GA",
            "country_code": "US",
            "postal_code": "319054464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua Scott Will, D.O.
• Craig Jeffrey Williams, DDS
• James Stratford Williams, PA-C
• Janice Williams
• Yolanda NMN Williams, LPN
• Zachery Willis
• Joshua Allen Wilson, MD
• Kelly Lynn Wilson
• Natalie Marie Wilson, CRNA
• Larry Andrew Wise, AU.D.

• Athletic Trainer in Fort Benning, GA
• Providers in Fort Benning, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.