Active NPI
Nicole Tomlinson Vanness, LICENSED ATC
- Athletic Trainer
- Mooresville, NC
National Provider Identifier
1679635106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0578
- Practice address
- 128 E Plaza Dr
Mooresville, NC 28115-8000 - Phone
- (704) 663-3777
- Fax
- (704) 664-6615
- NPI assigned
- Dec 14, 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 | 0578 | NC | Primary |
Addresses
Primary practice location
128 E Plaza Dr
Mooresville, NC 28115-8000
Mailing address
128 E Plaza Dr
Mooresville, NC 28115-8000
Phone (704) 663-3777
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 974768 | Other | NC | MEMBER |
| 0578 | Other | NC | NC LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0578 | NC | MD | Health Service Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679635106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 E PLAZA DR",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281158000",
"telephone_number": "704-663-3777",
"fax_number": "704-664-6615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 E PLAZA DR",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281158000",
"telephone_number": "704-663-3777",
"fax_number": "704-664-6615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOMLINSON VANNESS",
"first_name": "NICOLE",
"credential": "LICENSED ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NC",
"license": "0578",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEMBER",
"identifier": "974768",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC LICENSE",
"identifier": "0578",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mooresville, NC
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.