Active NPI
Andrew Warren Klock, ATC, LAT
- Athletic Trainer
- Gainesville, FL
National Provider Identifier
1720102403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT3301
- Practice address
- 3450 Hull Rd
Gainesville, FL 32607-4144 - Phone
- (352) 273-7001
- NPI assigned
- Mar 19, 2007
- Sex
- Male
- Sole proprietor
- No
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 | AT3301 | TX | Primary |
Addresses
Primary practice location
3450 Hull Rd
Gainesville, FL 32607-4144
Mailing address
3450 Hull Rd
Gainesville, FL 32607-4144
Phone (352) 273-7001
Other practice location 1
3500 Bellaire Dr
Walsh Complex Athletic Training Room
Fort Worth, TX 76129-0001
Phone (817) 257-5035
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 |
|---|---|---|---|
| AT3301 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671580800000",
"number": "1720102403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3450 HULL RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326074144",
"telephone_number": "352-273-7001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3450 HULL RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326074144",
"telephone_number": "352-273-7001"
}
],
"practiceLocations": [
{
"address_1": "3500 Bellaire Dr",
"address_2": "Walsh Complex Athletic Training Room",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "761290001",
"country_code": "US",
"telephone_number": "817-257-5035",
"fax_number": "817-257-7323",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KLOCK",
"first_name": "ANDREW",
"middle_name": "WARREN",
"name_prefix": "Mr.",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-19",
"last_updated": "2022-12-21",
"certification_date": "2022-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT3301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.