Active NPI
Kassidy Everhart, ATC
- Sports Medicine (Emergency Medicine) Physician
- Lexington, NC
National Provider Identifier
1447068614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Emergency Medicine) Physician
- License
- AT004504
- Practice address
- 4186 W Center Street Ext
Lexington, NC 27295-6205 - Phone
- (336) 650-2890
- NPI assigned
- Dec 20, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Emergency Medicine) Physician | 207PS0010X | AT004504 | GA | Primary |
Addresses
Primary practice location
4186 W Center Street Ext
Lexington, NC 27295-6205
Mailing address
4186 W Center Street Ext
Lexington, NC 27295-6205
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
| License | State | Type | Specialty |
|---|---|---|---|
| AT004504 | GA | MD | Sports Medicine (Emergency Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734652800000",
"number": "1447068614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4186 W CENTER STREET EXT",
"city": "LEXINGTON",
"state": "NC",
"postal_code": "272956205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4186 W CENTER STREET EXT",
"city": "LEXINGTON",
"state": "NC",
"postal_code": "272956205",
"telephone_number": "336-650-2890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERHART",
"first_name": "KASSIDY",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-20",
"last_updated": "2024-12-20",
"certification_date": "2024-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "207PS0010X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Sports Medicine",
"state": "GA",
"license": "AT004504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.