Tyron Devour Watkins, ATC/L

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL1802 Issued in FL

Practice address

640 Mary McLeod Bethune BL
Daytona Beach, FL 32114

Phone

(386) 481-2262

NPI assigned

Jun 29, 2006

Sex

Male

Sole proprietor

No

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, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922036045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 WOODCREST DR",
            "address_2": "APT 2203",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 MARY MCLEOD BETHUNE BL",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32114",
            "telephone_number": "386-481-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "TYRON",
        "middle_name": "DEVOUR",
        "credential": "ATC/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL1802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Henrinne Washington Sr., CNA
• Jasmine Washington
• Roger Washington Jr.
• Jeannine Renee Waterman, ARNP
• Elizabeth Juliette Watkins, LCSW
• Jaleel Watson
• Joseph Thomas Watson, D.P.M.
• Joslynn Watson, LMHC
• Lindsey Watson, APRN
• Mattie Marie Watson

• All providers in Daytona Beach, FL
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.