Individual provider Active NPI

James Thomas Mays II, MS ED., ATC

  • Athletic Trainer
  • Edwardsville, IL
National Provider Identifier
1689738247
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
Southern Illinois University -Edwardsville
Athletics, Box 1129
Edwardsville, IL 62026-1129
Phone
(618) 650-2160
NPI assigned
Dec 20, 2006
Sex
Male
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 IL Primary

Addresses

Primary practice location

Southern Illinois University -Edwardsville
Athletics, Box 1129
Edwardsville, IL 62026-1129

Mailing address

2201 Locust Ave
Alton, IL 62002-5348
Phone (618) 462-1471

Other identifiers 1

IdentifierTypeStateIssuer
08062276OtherILNATA BOC CERTIFICATION #

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
096002388ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689738247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 LOCUST AVE",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025348",
            "telephone_number": "618-462-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SOUTHERN ILLINOIS UNIVERSITY -EDWARDSVILLE",
            "address_2": "ATHLETICS, BOX 1129",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620261129",
            "telephone_number": "618-650-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYS",
        "first_name": "JAMES",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "MS ED., ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATA BOC CERTIFICATION #",
            "identifier": "08062276",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

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.