Active NPI
Timothy Wayne Horsley, ATC, LAT
- Athletic Trainer
- Roanoke, TX
National Provider Identifier
1609083682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT2861
- Practice address
- 121 Ellicott Dr.
Roanoke, TX 76262 - Phone
- (817) 854-0792
- NPI assigned
- May 17, 2007
- Last updated
- Jul 8, 2007
- 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 | AT2861 | TX | Primary |
Addresses
Primary practice location
121 Ellicott Dr.
Roanoke, TX 76262
Mailing address
121 Ellicott Dr.
Roanoke, TX 76262
Phone (817) 854-0792
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 |
|---|---|---|---|
| AT2861 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609083682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 ELLICOTT DR.",
"city": "ROANOKE",
"state": "TX",
"postal_code": "76262",
"telephone_number": "817-854-0792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 ELLICOTT DR.",
"city": "ROANOKE",
"state": "TX",
"postal_code": "76262",
"telephone_number": "817-854-0792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORSLEY",
"first_name": "TIMOTHY",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "ATC, LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT2861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, TX
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- Erin Hebert, AUD
- Yadira Guadalupe Hernandez, DC
- Kerry B Howell, LPC-S
- Ideal Dental of Roanoke PLLC
- Integrity Plus Healthcare Staffing, LLC
- JCK Love Home Care LLC
- Kathleen Leontine Jessen, OTR/L, IBCLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.