Active NPI
Christopher Ryan Leeds, MS, ATC, LAT
- Athletic Trainer
- Roswell, GA
National Provider Identifier
1356724595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT002376
- Practice address
- 11320 Woodstock Rd
Roswell, GA 30075-2548 - Phone
- (770) 255-5142
- NPI assigned
- Jul 7, 2015
- Last updated
- Jul 7, 2015
- Sex
- Male
- 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 | AT002376 | GA | Primary |
Addresses
Primary practice location
11320 Woodstock Rd
Roswell, GA 30075-2548
Mailing address
11320 Woodstock Rd
Roswell, GA 30075-2548
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT002376 | GA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436227200000",
"number": "1356724595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11320 WOODSTOCK RD",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300752548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11320 WOODSTOCK RD",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300752548",
"telephone_number": "770-255-5142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEEDS",
"first_name": "CHRISTOPHER",
"middle_name": "RYAN",
"credential": "MS, ATC, LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-07",
"last_updated": "2015-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT002376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.