Individual provider Active NPI

Trevor Wright Smith, ATC, LAT

  • Athletic Trainer
  • Euless, TX
National Provider Identifier
1801173778
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT2169 Issued in TX
Practice address
1813 Marlene Dr
Euless, TX 76040-4813
Phone
(817) 692-6430
NPI assigned
Nov 7, 2011
Last updated
Nov 7, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

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 AT2169 TX Primary

Addresses

Primary practice location

1813 Marlene Dr
Euless, TX 76040-4813

Mailing address

1813 Marlene Drive
Euless, TX 76040-4813
Phone (817) 692-6430

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
AT2169TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1320624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320624000000",
    "number": "1801173778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1813 MARLENE DRIVE",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760404813",
            "telephone_number": "817-692-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 MARLENE DR",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760404813",
            "telephone_number": "817-692-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TREVOR",
        "middle_name": "WRIGHT",
        "name_prefix": "Mr.",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-07",
        "last_updated": "2011-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT2169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Euless, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; 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.