Active NPI
Devin Neill, MS, LAT, ATC
- Athletic Trainer
- Canyon, TX
National Provider Identifier
1669078002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT7344
- Practice address
- 104 S 28TH St.
Canyon, TX 79015 - Phone
- (806) 651-3641
- NPI assigned
- Dec 10, 2020
- Sex
- Male
- 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 | AT7344 | TX | Primary |
Addresses
Primary practice location
104 S 28TH St.
Canyon, TX 79015
Mailing address
PO Box 612
Canyon, TX 79015-0612
Phone (504) 578-0405
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
| License | State | Type | Specialty |
|---|---|---|---|
| AT7344 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607558400000",
"number": "1669078002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 612",
"city": "CANYON",
"state": "TX",
"postal_code": "790150612",
"telephone_number": "504-578-0405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 S 28TH ST.",
"city": "CANYON",
"state": "TX",
"postal_code": "79015",
"telephone_number": "806-651-3641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEILL",
"first_name": "DEVIN",
"credential": "MS, LAT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-10",
"last_updated": "2020-12-10",
"certification_date": "2020-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT7344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canyon, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.