Active NPI
Cary Lynn Berthelot, MA, ATC, LAT
- Athletic Trainer
- Hammond, LA
National Provider Identifier
1649208166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- J-000310
- Practice address
- Slu Box 10845
Hammond, LA 70402-0001 - Phone
- (985) 549-2351
- NPI assigned
- Jun 30, 2006
- Sex
- Female
- Sole proprietor
- No
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 | J-000310 | LA | Primary |
Addresses
Primary practice location
Slu Box 10845
Hammond, LA 70402-0001
Mailing address
17274 Riverside LN
Tickfaw, LA 70466-2846
Phone (985) 429-0096
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J-000310 | LA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649208166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17274 RIVERSIDE LN",
"city": "TICKFAW",
"state": "LA",
"postal_code": "704662846",
"telephone_number": "985-429-0096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SLU BOX 10845",
"city": "HAMMOND",
"state": "LA",
"postal_code": "704020001",
"telephone_number": "985-549-2351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTHELOT",
"first_name": "CARY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "MA, ATC, LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "LA",
"license": "J-000310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hammond, LA
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.