Amanda Martin, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

215 Maynard Lake Rd
Erwin, NC 28339-8507

Phone

(937) 728-5749

NPI assigned

Oct 8, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1396116802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 W WASHINGTON ST",
            "city": "COATS",
            "state": "NC",
            "postal_code": "275218348",
            "telephone_number": "937-728-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MAYNARD LAKE RD",
            "city": "ERWIN",
            "state": "NC",
            "postal_code": "283398507",
            "telephone_number": "937-728-5749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1596 Ogden Rd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "OH",
            "postal_code": "451779189",
            "country_code": "US",
            "telephone_number": "937-382-0785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "AMANDA",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-08",
        "last_updated": "2024-05-16",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Erwin, NC
• Providers in Erwin, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.