Benjamin J Gearhart, ATC, LAT, MED.

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1662 Issued in AL

Practice address

75 College Dr
Montevallo, AL 35115-3732

Phone

(812) 603-4434

NPI assigned

Aug 19, 2014

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 19, 2014.

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1699174334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 COLLEGE DR",
            "city": "MONTEVALLO",
            "state": "AL",
            "postal_code": "351153732",
            "telephone_number": "812-603-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 COLLEGE DR",
            "city": "MONTEVALLO",
            "state": "AL",
            "postal_code": "351153732",
            "telephone_number": "812-603-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEARHART",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "ATC, LAT, MED.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AL",
            "license": "1662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Montevallo, AL
• Athletic Trainer in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.