Hollis Theard, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

LAT-2778 Issued in NC

Practice address

49464 Merner Terrace
Misenheimer, NC 28109

Phone

(704) 463-0567

NPI assigned

Feb 19, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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": "1424304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1912399569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 EASTWOOD DR",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281467063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49464 MERNER TERRACE",
            "city": "MISENHEIMER",
            "state": "NC",
            "postal_code": "28109",
            "telephone_number": "704-463-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEARD",
        "first_name": "HOLLIS",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-19",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT001791",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-2778",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "LA",
            "license": "ATH.200482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolinas Physicians Network Inc (Pfeiffer Health Services)
• Darci Dickison, LATC
• Brandon Scott Johnson, LAT, ATC
• Pfeiffer University Sports Medicine
• Stanly Medical Services (Pfeiffer Health Services)

• Athletic Trainer in Misenheimer, NC
• Providers in Misenheimer, 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 Sep 9, 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.

Verify at the official NPI Registry.