Active NPI
Clayton Sibley, ATC, LAT
- Athletic Trainer
- Batesville, MS
National Provider Identifier
1518555333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-0869
- Practice address
- 287 Ms-6
Batesville, MS 38606 - Phone
- (662) 578-7799
- NPI assigned
- Jan 7, 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 | AT-0869 | MS | Primary |
Addresses
Primary practice location
287 Ms-6
Batesville, MS 38606
Mailing address
61 Sullivant Rd
Batesville, MS 38606-9548
Phone (166) 293-4425
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000028584 | Other | BOARD OF CERTIFICATION FOR THE ATHLETIC TRAINER | |
| AT-0869 | Other | MS | MISSISSIPPI LICENSE FOR ATHLETIC TRAINING |
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 |
|---|---|---|---|
| AT-0869 | MS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609977600000",
"number": "1518555333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61 SULLIVANT RD",
"city": "BATESVILLE",
"state": "MS",
"postal_code": "386069548",
"telephone_number": "166-293-4425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "287 MS-6",
"city": "BATESVILLE",
"state": "MS",
"postal_code": "38606",
"telephone_number": "662-578-7799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIBLEY",
"first_name": "CLAYTON",
"credential": "ATC, LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-07",
"last_updated": "2021-01-07",
"certification_date": "2020-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MS",
"license": "AT-0869",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF CERTIFICATION FOR THE ATHLETIC TRAINER",
"identifier": "2000028584",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MISSISSIPPI LICENSE FOR ATHLETIC TRAINING",
"identifier": "AT-0869",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Batesville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.