Active NPI
Ryan Schrader
- Athletic Trainer
- Hattiesburg, MS
National Provider Identifier
1891104238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- ATC0623
- Practice address
- 6134 U S Highway 98
Hattiesburg, MS 39402-8530 - Phone
- (601) 336-7155
- Fax
- (601) 336-7782
- NPI assigned
- Aug 11, 2014
- Sex
- Male
- Sole proprietor
- No
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 | ATC0623 | MS | Primary |
Addresses
Primary practice location
6134 U S Highway 98
Hattiesburg, MS 39402-8530
Mailing address
2416 Highway 45 N
Columbus, MS 39705-1320
Phone (662) 327-6705
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 |
|---|---|---|---|
| ATC0623 | MS | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Drayer Physical Therapy Mississippi LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapist
- Louisville, MS
- NPI 1952732448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407715200000",
"number": "1891104238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2416 HIGHWAY 45 N",
"city": "COLUMBUS",
"state": "MS",
"postal_code": "397051320",
"telephone_number": "662-327-6705",
"fax_number": "662-327-6760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6134 U S HIGHWAY 98",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394028530",
"telephone_number": "601-336-7155",
"fax_number": "601-336-7782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHRADER",
"first_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-11",
"last_updated": "2014-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MS",
"license": "ATC0623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.