Individual provider Active NPI

Amy Jo Gatens, MS, ATC, LAT

  • Athletic Trainer
  • Davie, FL
National Provider Identifier
1770806085
Registry record updated Jul 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL 1864 Issued in FL
Practice address
3301 College Ave
Department of Athletics
Davie, FL 33314-7721
Phone
(954) 262-8256
Fax
(954) 262-3740
NPI assigned
Mar 2, 2010
Last updated
Jul 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 AL 1864 FL Primary

Addresses

Primary practice location

3301 College Ave
Department of Athletics
Davie, FL 33314-7721

Mailing address

3301 College Ave
Department of Athletics
Davie, FL 33314-7721
Phone (954) 262-8256

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
AL 1864FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1770806085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 COLLEGE AVE",
            "address_2": "DEPARTMENT OF ATHLETICS",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333147721",
            "telephone_number": "954-262-8256",
            "fax_number": "954-262-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 COLLEGE AVE",
            "address_2": "DEPARTMENT OF ATHLETICS",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333147721",
            "telephone_number": "954-262-8256",
            "fax_number": "954-262-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATENS",
        "first_name": "AMY",
        "middle_name": "JO",
        "credential": "MS, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-02",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL 1864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.