Active NPI
Sean Ross Huddleston, ATC
- Athletic Trainer
- Springdale, AR
National Provider Identifier
1710235080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT 567
- Practice address
- 1350 S Gutensohn Rd
#10
Springdale, AR 72762-5117 - Phone
- (479) 751-7122
- NPI assigned
- Aug 16, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 | AT 567 | AR | Primary |
Addresses
Primary practice location
1350 S Gutensohn Rd
#10
Springdale, AR 72762-5117
Mailing address
2858 W Redstone Dr
Fayetteville, AR 72704-5139
Phone (417) 239-4242
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 |
|---|---|---|---|
| AT 567 | AR | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345075200000",
"number": "1710235080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2858 W REDSTONE DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727045139",
"telephone_number": "417-239-4242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 S GUTENSOHN RD",
"address_2": "#10",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727625117",
"telephone_number": "479-751-7122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDDLESTON",
"first_name": "SEAN",
"middle_name": "ROSS",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-16",
"last_updated": "2012-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AR",
"license": "AT 567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.