Active NPI
Derek Stevenson, LAT, ATC
- Athletic Trainer
- Leander, TX
National Provider Identifier
1710387469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT5275
- Practice address
- 227 Hoot Owl LN N
Leander, TX 78641-1733 - Phone
- (512) 297-3126
- NPI assigned
- Aug 31, 2014
- 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 | AT5275 | TX | Primary |
Addresses
Primary practice location
227 Hoot Owl LN N
Leander, TX 78641-1733
Mailing address
227 Hoot Owl LN N
Leander, TX 78641-1733
Phone (512) 297-3126
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AT5275 | Other | TX | LICENSED ATHLETIC TRAINER |
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 |
|---|---|---|---|
| AT5275 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409443200000",
"number": "1710387469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 HOOT OWL LN N",
"city": "LEANDER",
"state": "TX",
"postal_code": "786411733",
"telephone_number": "512-297-3126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "227 HOOT OWL LN N",
"city": "LEANDER",
"state": "TX",
"postal_code": "786411733",
"telephone_number": "512-297-3126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENSON",
"first_name": "DEREK",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-31",
"last_updated": "2014-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT5275",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED ATHLETIC TRAINER",
"identifier": "AT5275",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leander, TX
- St. David's Healthcare Partnership, L.P., LLP (St. David's Emergency Center-Leander, a department of St. David's Round Rock Medical Center)
- Michael Ann Starr, LCSW, RPT
- Sid Kelly Steadman, DDS
- Robert Steinbach
- Zanna Haney Stevanovic, LPC
- Bonnie Stice, MA, LPC
- Still Point Physical Therapy and Wellness P.L.L.C
- Chaithra Sujeevan
- Farhin Sunesara, DMD
- Alkesh Chandrakant Sura, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.