Individual provider Active NPI

Andrew David Hinds, ATC

  • Athletic Trainer
  • Mt Vernon, IL
National Provider Identifier
1407372709
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096005375 Issued in IL
Practice address
11525 North Illinois Highway 142
Mt Vernon, IL 62864
Phone
(618) 246-2369
NPI assigned
Aug 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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 1868 TN
Athletic Trainer 2255A2300X 096005375 IL Primary

Addresses

Primary practice location

11525 North Illinois Highway 142
Mt Vernon, IL 62864

Mailing address

1 Cumberland SQ
Lebanon, TN 37087-3408

Other practice location 1

325 Cherry Ave
Mc Kenzie, TN 38201-1769
Phone (731) 352-4000

Other practice location 2

325 Cherry Ave
Mc Kenzie, TN 38201-1769
Phone (731) 352-4000

Other practice location 3

1 Cumberland Sq
Lebanon, TN 37087
Phone (615) 547-1229

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

State licenses

LicenseStateTypeSpecialty
096005375ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1407372709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CUMBERLAND SQ",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11525 NORTH ILLINOIS HIGHWAY 142",
            "city": "MT VERNON",
            "state": "IL",
            "postal_code": "62864",
            "telephone_number": "618-246-2369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 Cherry Ave",
            "address_purpose": "LOCATION",
            "city": "Mc Kenzie",
            "state": "TN",
            "postal_code": "382011769",
            "country_code": "US",
            "telephone_number": "731-352-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 Cherry Ave",
            "address_purpose": "LOCATION",
            "city": "Mc Kenzie",
            "state": "TN",
            "postal_code": "382011769",
            "country_code": "US",
            "telephone_number": "731-352-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Cumberland Sq",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "TN",
            "postal_code": "37087",
            "country_code": "US",
            "telephone_number": "615-547-1229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINDS",
        "first_name": "ANDREW",
        "middle_name": "DAVID",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-17",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "1868",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096005375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.