Active NPI
Kyle Garber Beatty, ATC
- Athletic Trainer
- Durham, NC
National Provider Identifier
1780646893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1600
- Practice address
- 120 Whitford Dr
Yoh Football Center
Durham, NC 27708-9982 - Phone
- (919) 681-1422
- Fax
- (919) 684-2102
- NPI assigned
- Apr 4, 2006
- 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 | 1600 | NC | Primary |
Addresses
Primary practice location
120 Whitford Dr
Yoh Football Center
Durham, NC 27708-9982
Mailing address
120 Whitford Dr
Durham, NC 27708-9982
Phone (919) 681-1422
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070402702 | Other | VA | NATA BOC NUMBER |
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 |
|---|---|---|---|
| 1600 | NC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423872000000",
"number": "1780646893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 WHITFORD DR",
"city": "DURHAM",
"state": "NC",
"postal_code": "277089982",
"telephone_number": "919-681-1422",
"fax_number": "919-684-2102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 WHITFORD DR",
"address_2": "YOH FOOTBALL CENTER",
"city": "DURHAM",
"state": "NC",
"postal_code": "277089982",
"telephone_number": "919-681-1422",
"fax_number": "919-684-2102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEATTY",
"first_name": "KYLE",
"middle_name": "GARBER",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-04",
"last_updated": "2015-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NC",
"license": "1600",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATA BOC NUMBER",
"identifier": "070402702",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.