Active NPI
Kaitlyn Meyers, LAT, ATC
- Athletic Trainer
- Statesboro, GA
National Provider Identifier
1780140897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT003367
- Practice address
- 590 Herty Drive
Statesboro, GA 30458 - Phone
- (912) 478-1220
- NPI assigned
- Feb 13, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | AT003367 | GA | Primary |
Addresses
Primary practice location
590 Herty Drive
Statesboro, GA 30458
Mailing address
256 S Clinton Ave
Lindenhurst, NY 11757-5111
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 |
|---|---|---|---|
| AT003367 | GA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601510400000",
"number": "1780140897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "256 S CLINTON AVE",
"city": "LINDENHURST",
"state": "NY",
"postal_code": "117575111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 HERTY DRIVE",
"city": "STATESBORO",
"state": "GA",
"postal_code": "30458",
"telephone_number": "912-478-1220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEYERS",
"first_name": "KAITLYN",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-13",
"last_updated": "2020-10-01",
"certification_date": "2020-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT003367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Statesboro, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.