Active NPI
Janece A Risty, ATC
- Athletic Trainer
- Newnan, GA
National Provider Identifier
1790951168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT002419
- Practice address
- 85 Brookstone CRST
Newnan, GA 30265-3852 - Phone
- (770) 755-8768
- NPI assigned
- May 5, 2008
- 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 | AT002419 | GA | Primary |
Addresses
Primary practice location
85 Brookstone CRST
Newnan, GA 30265-3852
Mailing address
85 Brookstone CRST
Newnan, GA 30265-3852
Phone (770) 755-8768
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AT002419 | Other | GA | PROFESSIONAL LICENSING STATE OF GEORGIA |
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 |
|---|---|---|---|
| AT002419 | GA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404950400000",
"number": "1790951168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 BROOKSTONE CRST",
"city": "NEWNAN",
"state": "GA",
"postal_code": "302653852",
"telephone_number": "770-755-8768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 BROOKSTONE CRST",
"city": "NEWNAN",
"state": "GA",
"postal_code": "302653852",
"telephone_number": "770-755-8768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RISTY",
"first_name": "JANECE",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-05",
"last_updated": "2014-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT002419",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROFESSIONAL LICENSING STATE OF GEORGIA",
"identifier": "AT002419",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newnan, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.