Active NPI
Tyler Stephen Lowe, LAT, ATC
- Athletic Trainer
- Valdosta, GA
National Provider Identifier
1487237525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT003734
- Practice address
- 5774 Fontana Rd
Valdosta, GA 31601-2481 - Phone
- (478) 595-3858
- NPI assigned
- May 5, 2021
- Last updated
- May 5, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | AT003734 | GA | Primary |
Addresses
Primary practice location
5774 Fontana Rd
Valdosta, GA 31601-2481
Mailing address
5774 Fontana Rd
Valdosta, GA 31601-2481
Phone (478) 595-3858
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AT003734 | Other | GA | GEORGIA SECRETARY OF STATE |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1487237525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5774 FONTANA RD",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316012481",
"telephone_number": "478-595-3858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5774 FONTANA RD",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316012481",
"telephone_number": "478-595-3858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOWE",
"first_name": "TYLER",
"middle_name": "STEPHEN",
"name_prefix": "Mr.",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-05",
"last_updated": "2021-05-05",
"certification_date": "2021-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT003734",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEORGIA SECRETARY OF STATE",
"identifier": "AT003734",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Valdosta, GA
- Halleigh Lane Lovein, NP
- Sara Melissa Lovette, NP-C
- Elizabeth Haslup Lowe, MD
- Quintorya Lowe
- Shalonda Lowe, BSW
- Kelly Lowery, DNP, FNP-BC
- Lacey L Lowery, MED, CCC-SLP
- Lowndes Advocacy Resource Center, Inc (Larc)
- Lowndes County Ambulatory Surgical Center
- Lowndes County Health Services LLC (PruittHealth - Crestwood)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.