Individual provider Active NPI

Shannon Thornhill

  • Athletic Trainer
  • Virginia BCH, VA
National Provider Identifier
1770128662
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0202012896 Issued in VA
Practice address
2025 Grandon Loop Rd
Virginia BCH, VA 23456-3517
Phone
(757) 373-6692
NPI assigned
Nov 14, 2019
Last updated
Nov 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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 0202012896 VA Primary

Addresses

Primary practice location

2025 Grandon Loop Rd
Virginia BCH, VA 23456-3517

Mailing address

2025 Grandon Loop Rd
Virginia BCH, VA 23456-3517
Phone (757) 373-6692

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
0202012896VAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1770128662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 GRANDON LOOP RD",
            "city": "VIRGINIA BCH",
            "state": "VA",
            "postal_code": "234563517",
            "telephone_number": "757-373-6692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 GRANDON LOOP RD",
            "city": "VIRGINIA BCH",
            "state": "VA",
            "postal_code": "234563517",
            "telephone_number": "757-373-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNHILL",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0202012896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia BCH, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.