Individual provider Active NPI

Mary Elizabeth Branch, MS, ATC

  • Athletic Trainer
  • Kingsland, GA
National Provider Identifier
1679500615
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
1300 Middle School Rd
Kingsland, GA 31548-6208
Phone
(912) 729-3113
NPI assigned
Jun 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 GA Primary

Addresses

Primary practice location

1300 Middle School Rd
Kingsland, GA 31548-6208

Mailing address

13 Deals Cir S
Woodbine, GA 31569-2827
Phone (912) 673-9454

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

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679500615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 DEALS CIR S",
            "city": "WOODBINE",
            "state": "GA",
            "postal_code": "315692827",
            "telephone_number": "912-673-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MIDDLE SCHOOL RD",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486208",
            "telephone_number": "912-729-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANCH",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsland, GA

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.

Verify at the official NPI Registry.