Individual provider Active NPI

Kayleigh Dolphin, MS, LAT, ATC, CES

  • Athletic Trainer
  • Clayton, NC
National Provider Identifier
1871110411
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
LAT-2939 Issued in NC
Practice address
166 Springbrook Ave Ste 201
Clayton, NC 27520-8520
Phone
(919) 535-8461
Fax
(919) 535-8459
NPI assigned
Jun 30, 2020
Last updated
Mar 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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 LAT-2939 NC Primary

Addresses

Primary practice location

166 Springbrook Ave Ste 201
Clayton, NC 27520-8520

Mailing address

166 Springbrook Ave Ste 201
Clayton, NC 27520-8520
Phone (919) 535-8461

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LAT-2939NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Activcare Physical Therapy, LLC CurrentSince Mar 16, 2021 Accepting new patients

Locations

166 Springbrook Ave
Ste 201
Clayton, NC 27520
Phone (919) 535-8461

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1871110411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 SPRINGBROOK AVE STE 201",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275208520",
            "telephone_number": "919-535-8461",
            "fax_number": "919-535-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 SPRINGBROOK AVE STE 201",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275208520",
            "telephone_number": "919-535-8461",
            "fax_number": "919-535-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLPHIN",
        "first_name": "KAYLEIGH",
        "credential": "MS, LAT, ATC, CES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-2939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.