Candace Lakeybra Dawn Ballard
Individual provider Active NPI Athletic Trainer · Carthage, TX
NPI 1376401455 · NPPES record last updated Jan 15, 2026
Key facts
- NPI
- 1376401455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 901 S Adams St Apt 23
Carthage, TX 75633-2962 - Phone
- (903) 261-1668
- NPI assigned
- Jan 15, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
901 S Adams St Apt 23
Carthage, TX 75633-2962
Mailing address
901 S Adams St Apt 23
Carthage, TX 75633-2962
Other providers in Carthage, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.