Individual provider Active NPI

Emily Ida Evans, MS, ATC, CMT

  • Athletic Trainer
  • Lynchburg, VA
National Provider Identifier
1629314968
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126000379 Issued in VA
Practice address
1501 Lakeside Dr
Lynchburg, VA 24501-3113
Phone
(434) 544-8649
NPI assigned
Dec 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

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 0126000379 VA Primary

Addresses

Primary practice location

1501 Lakeside Dr
Lynchburg, VA 24501-3113

Mailing address

1501 Lakeside Dr
Lynchburg, VA 24501-3113
Phone (434) 544-8649

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0126000379VAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1629314968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 LAKESIDE DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245013113",
            "telephone_number": "434-544-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 LAKESIDE DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245013113",
            "telephone_number": "434-544-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "EMILY",
        "middle_name": "IDA",
        "name_prefix": "Mrs.",
        "credential": "MS, ATC, CMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-13",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126000379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; 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.