Daniel Cadavid Duque, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT002987 Issued in GA

Practice address

684 Sixes Rd Ste 130
Holly Springs, GA 30115-8758

Phone

(770) 517-6636

NPI assigned

Jun 1, 2017

Last updated

Jun 1, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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 Science

State licenses

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496275200000",
    "number": "1417485608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 VERNEER CT",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883620",
            "telephone_number": "404-729-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 SIXES RD STE 130",
            "city": "HOLLY SPRINGS",
            "state": "GA",
            "postal_code": "301158758",
            "telephone_number": "770-517-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CADAVID DUQUE",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-01",
        "last_updated": "2017-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT002987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Michelle Bell, PA-C
• Mary Blalock
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• Randall James Boyd, D.C.
• Karen Buhariwalla, D.O.
• Courtney Brynne Campbell, PA-C
• Daquesha Capre Chever, D.O
• Sydney Anabel Colon, APRN-FNP
• Sarah Scott Cool
• Stacey Collene Cox, N.P.-C

• Athletic Trainer in Holly Springs, GA
• Providers in Holly Springs, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2017; 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.