Darrell Layne Ganus, MED, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1246 Issued in TX

Practice address

301 N Kilgore St
Kilgore, TX 75662-5825

Phone

(903) 983-3307

Fax

(903) 983-3211

NPI assigned

Mar 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kilgore Independent School District

  • Local Education Agency (LEA)
  • Kilgore, TX
  • NPI 1144376278
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417086141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 WOODLAWN ST",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623650",
            "telephone_number": "903-983-3307",
            "fax_number": "903-983-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N KILGORE ST",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756625825",
            "telephone_number": "903-983-3307",
            "fax_number": "903-983-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANUS",
        "first_name": "DARRELL",
        "middle_name": "LAYNE",
        "name_prefix": "Mr.",
        "credential": "MED, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "1246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle David Ferro, D.D.S.
• Russell C Fisher, R.PH.
• James E. Foster, MD
• Jennifer Darlene Franks, BSN RN
• La Tamera D Fry, LAT
• Michael Gardner, D.D.S.
• Get to the Point Wellness PLLC
• Shirley Jane Goetze, CCC/SLP
• Paul A Grant Jr, MD
• Grant-Moore Center for Behavioral Health, Inc.

• Athletic Trainer in Kilgore, TX
• Providers in Kilgore, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.