Active NPI
Susan Yeargin, ATC
- Athletic Trainer
- Columbia, SC
National Provider Identifier
1831581511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1365
- Practice address
- 1300 Wheat St
Blatt, RM 218N
Columbia, SC 29208-0001 - Phone
- (803) 777-3169
- NPI assigned
- Mar 4, 2015
- 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 | 1365 | SC | Primary |
Addresses
Primary practice location
1300 Wheat St
Blatt, RM 218N
Columbia, SC 29208-0001
Mailing address
110 Saints Creek LN
Irmo, SC 29063-8158
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 |
|---|---|---|---|
| 1365 | SC | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425427200000",
"number": "1831581511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 SAINTS CREEK LN",
"city": "IRMO",
"state": "SC",
"postal_code": "290638158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 WHEAT ST",
"address_2": "BLATT, RM 218N",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292080001",
"telephone_number": "803-777-3169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YEARGIN",
"first_name": "SUSAN",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-04",
"last_updated": "2015-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SC",
"license": "1365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.