Active NPI
Mary E. Sult, LAT, ATC, ROT
- Athletic Trainer
- High Point, NC
National Provider Identifier
1467601229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1628
- Practice address
- 860 Lakecrest Ave Apt 2B
High Point, NC 27265-2683 - Phone
- (336) 906-0324
- NPI assigned
- Sep 16, 2008
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1628 | NC | Primary |
Addresses
Primary practice location
860 Lakecrest Ave Apt 2B
High Point, NC 27265-2683
Mailing address
860 Lakecrest Ave Apt 2B
High Point, NC 27265-2683
Phone (336) 906-0324
Other practice location 1
3605 Old Greensboro Rd
Winston Salem, NC 27101-2033
Phone (336) 978-3297
Other practice location 2
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 906-0324
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 091817050 | Other | AMERICAN SOCIETY OF ORTHOPEDIC PROFESSIONALS | |
| 030802029 | Other | BOARD OF CERTIFICATION, INC | |
| 1628 | Other | NC | NORTH CAROLINA BOARD OF ATHLETIC TRAINER EXAMINERS |
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 |
|---|---|---|---|
| 1628 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524182400000",
"number": "1467601229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "860 LAKECREST AVE APT 2B",
"city": "HIGH POINT",
"state": "NC",
"postal_code": "272652683",
"telephone_number": "336-906-0324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 LAKECREST AVE APT 2B",
"city": "HIGH POINT",
"state": "NC",
"postal_code": "272652683",
"telephone_number": "336-906-0324"
}
],
"practiceLocations": [
{
"address_1": "3605 Old Greensboro Rd",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "271012033",
"country_code": "US",
"telephone_number": "336-978-3297",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3333 Silas Creek Pkwy",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "271033013",
"country_code": "US",
"telephone_number": "336-906-0324",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SULT",
"first_name": "MARY",
"middle_name": "E.",
"credential": "LAT, ATC, ROT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-16",
"last_updated": "2018-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NC",
"license": "1628",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SOCIETY OF ORTHOPEDIC PROFESSIONALS",
"identifier": "091817050",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF CERTIFICATION, INC",
"identifier": "030802029",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH CAROLINA BOARD OF ATHLETIC TRAINER EXAMINERS",
"identifier": "1628",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in High Point, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.