Individual provider Active NPI

Caroline Taylor, MS, ATC

  • Athletic Trainer
  • Fairfax, VA
National Provider Identifier
1396891503
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126001169 Issued in VA
Practice address
5450 Crows Nest CT
Fairfax, VA 22032-3304
Phone
(540) 664-6541
NPI assigned
Jan 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Athletic Trainer 2255A2300X 0126001169 VA Primary

Addresses

Primary practice location

5450 Crows Nest CT
Fairfax, VA 22032-3304

Mailing address

5450 Crows Nest CT
Fairfax, VA 22032-3304
Phone (540) 664-6541

Other practice location 1

9333 Wax Myrtle Way
Manassas, VA 20110-5979
Phone (703) 368-1817

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

LicenseStateTypeSpecialty
0126001169VAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1396891503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 CROWS NEST CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220323304",
            "telephone_number": "540-664-6541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 CROWS NEST CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220323304",
            "telephone_number": "540-664-6541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9333 Wax Myrtle Way",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201105979",
            "country_code": "US",
            "telephone_number": "703-368-1817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "CAROLINE",
        "credential": "MS, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126001169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.