Cole Edward Dearing, MAT, LAT, ATC
Individual provider Active NPI Athletic Trainer · Kenton, OH
NPI 1619657012 · NPPES record last updated Jun 10, 2024
Key facts
- NPI
- 1619657012
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- AT006979 (OH)
- Practice address
- 13720 State Route 292
Kenton, OH 43326-9064 - Phone
- (567) 674-4267
- NPI assigned
- Jul 20, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT006979 | OH | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | OH | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | AT006979 | OH | Yes |
Addresses
Primary practice location
13720 State Route 292
Kenton, OH 43326-9064
Mailing address
13720 State Route 292
Kenton, OH 43326-9064
Phone (567) 674-4267
Other providers in Kenton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.