Individual provider Active NPI

Shang-Chien Lin, MS, ATC, CES

  • Athletic Trainer
  • Athens, OH
National Provider Identifier
1871962969
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL5362 Issued in FL
Practice address
200 Richland Ave
Athens, OH 45701
Phone
(740) 593-0458
Fax
(740) 597-3023
NPI assigned
Sep 18, 2015
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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 AL5362 FL Primary

Addresses

Primary practice location

200 Richland Ave
Athens, OH 45701

Mailing address

1033 2ND St Apt 42
Lafayette, CA 94549-3946
Phone (803) 979-9214

Other practice location 1

5821 San Amaro Dr
Coral Gables, FL 33146-2402
Phone (305) 284-2263

Other practice location 2

2227 Piedmont Ave
Berkeley, CA 94720-2402
Phone (510) 642-4878

Other names 1

  • Mr. Jerry Lin Other name

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
AL5362FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1871962969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 2ND ST APT 42",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493946",
            "telephone_number": "803-979-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 RICHLAND AVE",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "45701",
            "telephone_number": "740-593-0458",
            "fax_number": "740-597-3023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5821 San Amaro Dr",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331462402",
            "country_code": "US",
            "telephone_number": "305-284-2263",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2227 Piedmont Ave",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947202402",
            "country_code": "US",
            "telephone_number": "510-642-4878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIN",
        "first_name": "SHANG-CHIEN",
        "name_prefix": "Mr.",
        "credential": "MS, ATC, CES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-18",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL5362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERRY",
            "last_name": "LIN",
            "prefix": "MR.",
            "credential": "MS, ATC, CES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Athens, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.