Individual provider Active NPI

Amanda L Ozolins, ATC

  • Athletic Trainer
  • Pendleton, SC
National Provider Identifier
1750703245
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
1569 Issued in SC
Practice address
126 Lodge Rd
Lot 9
Pendleton, SC 29670-9267
Phone
(864) 356-7203
NPI assigned
Jan 17, 2014
Last updated
Jan 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1569 SC Primary

Addresses

Primary practice location

126 Lodge Rd
Lot 9
Pendleton, SC 29670-9267

Mailing address

126 Lodge Rd
Lot 9
Pendleton, SC 29670-9267
Phone (864) 356-7203

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

LicenseStateTypeSpecialty
1569SCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1750703245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 LODGE RD",
            "address_2": "LOT 9",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296709267",
            "telephone_number": "864-356-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 LODGE RD",
            "address_2": "LOT 9",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296709267",
            "telephone_number": "864-356-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OZOLINS",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-17",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "1569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.