Devon Fraker Gatewood

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0126001869 Issued in VA

Practice address

8500 Otterburn Rd
Amelia Court House, VA 23002-4849

Phone

(610) 551-7744

NPI assigned

Apr 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1487236261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 GRAVEL HILL RD",
            "city": "FORK UNION",
            "state": "VA",
            "postal_code": "230552104",
            "telephone_number": "610-551-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 OTTERBURN RD",
            "city": "AMELIA COURT HOUSE",
            "state": "VA",
            "postal_code": "230024849",
            "telephone_number": "610-551-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATEWOOD",
        "first_name": "DEVON",
        "middle_name": "FRAKER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126001869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gatewoodd@ameliaschools.com",
            "affiliation": "N",
            "address_1": "8500 Otterburn Rd",
            "city": "Amelia Court House",
            "state": "VA",
            "country_code": "US",
            "postal_code": "230024849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Athletic Trainer in Amelia Court House, VA
• Providers in Amelia Court House, VA by specialty
• Athletic Trainer in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.