Shane Anthony Barnes, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

6655 Issued in FL

Practice address

2100 Summerfield Rd
Winter Park, FL 32792-5037

Phone

(407) 277-5861

NPI assigned

Mar 15, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1528643103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 SUMMERFIELD RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327925037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SUMMERFIELD RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327925037",
            "telephone_number": "407-277-5861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Central Florida Blvd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328168005",
            "country_code": "US",
            "telephone_number": "407-403-4959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARNES",
        "first_name": "SHANE",
        "middle_name": "ANTHONY",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-15",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "6655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian K. Barnard, M.D.
• Victor Dorian Barnard, PA-C
• Cloe Barnes, DC
• Destinee Ruby Barnes
• Kiyontre Tyqwan Barnes
• Shari K Barnes
• Shawna Noelle Barnes, BSW, AND MSW
• Brittny Barnett, BA, MS
• Emily Kathryn Barnett, ARNP
• John Elias Barnett, AP

• Athletic Trainer in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.