Individual provider Active NPI

Lloyd Timothy McLane, ATC

  • Athletic Trainer
  • Augusta, GA
National Provider Identifier
1508895111
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL0000001 Issued in FL
Practice address
937 15TH St
Augusta, GA 30912-0008
Phone
(706) 836-6949
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AL0000001 FL Primary

Addresses

Primary practice location

937 15TH St
Augusta, GA 30912-0008

Mailing address

1051 Alder Way
Apt 407
Evans, GA 30809-9119
Phone (904) 476-8459

Other identifiers 4

IdentifierTypeStateIssuer
AL0000001OtherFLSTATE LICENSE
1326OtherSCSTATE LICENSES
AT001723OtherGASTATE LICENSE
000090290OtherNATIONAL BOARD

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

LicenseStateTypeSpecialty
AL0000001FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1508895111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 ALDER WAY",
            "address_2": "APT 407",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308099119",
            "telephone_number": "904-476-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120008",
            "telephone_number": "706-836-6949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLANE",
        "first_name": "LLOYD",
        "middle_name": "TIMOTHY",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL0000001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "AL0000001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSES",
            "identifier": "1326",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "AT001723",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL BOARD",
            "identifier": "000090290",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; 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.