Brandon Smith, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2878 Issued in NC

Practice address

133 Eagle CT
Mooresville, NC 28117-8022

Phone

(704) 677-5746

NPI assigned

Jan 20, 2017

Last updated

Jan 20, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1801333471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 EAGLE CT",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178022",
            "telephone_number": "704-677-5746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 EAGLE CT",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178022",
            "telephone_number": "704-677-5746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRANDON",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "2878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF CERTIFICATION FOR THE ATHLETIC TRAINER",
            "identifier": "2000022228",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA BOARD OF ATHLETIC TRAINER EXAMINERS",
            "identifier": "LAT-2878",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay Sloop
• Derek James Slovak, D.P.M
• Margaret Ann Small, PA-C
• Erica Lynn Smalla, LCSWA, MED, MSW
• Amy Smith
• Daniel Lee Smith
• Elizabeth Smith
• Heather Jeanette Smith, M.A., CCC-SLP
• Holly Routh Smith, MA, CCC-SLP
• Kristie D. Smith, ARNP

• Athletic Trainer in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.