Individual provider Active NPI

David Hunter Yentzen, ATC

  • Athletic Trainer
  • Byram, MS
National Provider Identifier
1427458546
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT0448 Issued in MS
Practice address
7213 S Siwell Rd Ste a
Byram, MS 39272-9776
Phone
(601) 346-9191
NPI assigned
Aug 26, 2014
Sex
Male
Sole proprietor
No

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT0448 MS Primary

Addresses

Primary practice location

7213 S Siwell Rd Ste a
Byram, MS 39272-9776

Mailing address

7213 S Siwell Rd Ste a
Byram, MS 39272-9776

Other practice location 1

290 E Layfair Dr Ste A
Flowood, MS 39232-9526
Phone (601) 987-8200

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
AT0448MSMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Orthopaedic Clinic, PLLC Past Accepting new patients
Capital Orthopaedic Clinic PLLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1427458546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7213 S SIWELL RD STE A",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392729776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7213 S SIWELL RD STE A",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392729776",
            "telephone_number": "601-346-9191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 E Layfair Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Flowood",
            "state": "MS",
            "postal_code": "392329526",
            "country_code": "US",
            "telephone_number": "601-987-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YENTZEN",
        "first_name": "DAVID",
        "middle_name": "HUNTER",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MS",
            "license": "AT0448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Byram, MS

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.