Ian Christopher Stites, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL 2989 Issued in FL

Practice address

O&C BLDG M7 0355 Mail Code Iha 008
Kennedy Space Center, FL 32899-0001

Phone

(321) 867-8004

Fax

(321) 867-1144

NPI assigned

Mar 5, 2015

Last updated

Mar 5, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1497148191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "O&C BLDG M7 0355 MAIL CODE IHA 008",
            "city": "KENNEDY SPACE CENTER",
            "state": "FL",
            "postal_code": "328990001",
            "telephone_number": "321-867-8004",
            "fax_number": "321-867-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "O&C BLDG M7 0355 MAIL CODE IHA 008",
            "city": "KENNEDY SPACE CENTER",
            "state": "FL",
            "postal_code": "328990001",
            "telephone_number": "321-867-8004",
            "fax_number": "321-867-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STITES",
        "first_name": "IAN",
        "middle_name": "CHRISTOPHER",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-05",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL 2989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Everett Cordie Cooper III, M.D.
• John Joseph Darwood, M.D.
• Frederick Allen Hauser Jr., D.O. MPH
• Mary Kathleen Kirkland, MS, ATC, LAT, CSCS
• Violette W Salib, M.D.
• Steven P. Taubkin, M.D.
• David Allen Tipton, M.D.
• Nicole Yacobino

• Athletic Trainer in Kennedy Space Center, FL
• Providers in Kennedy Space Center, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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.