Gina C Lee, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT003167 Issued in GA

Practice address

332 Jetta LN
Canton, GA 30115-8614

Phone

(678) 787-7473

NPI assigned

Oct 1, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1710528823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 JETTA LN",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158614",
            "telephone_number": "678-787-7473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 JETTA LN",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158614",
            "telephone_number": "678-787-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "GINA",
        "middle_name": "C",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-01",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT003167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dwayne Lay, DPM
• Jessica Leach
• Lead to Learn LLC
• Charles D. Lecroy, D.C.
• Ester Lee, PHARMD
• Seema Kansal Lee, MD
• Spencer Michael Lee, M.D.
• Tegan Jean Legendre, BCBA
• Kalum Leiba, CAA
• Natanel Leibu, MD

• Athletic Trainer in Canton, GA
• Providers in Canton, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.