Individual provider Active NPI

Leslie Page Sherrill, ATC

  • Athletic Trainer
  • Augusta, GA
National Provider Identifier
1932347333
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT000785 Issued in GA
Practice address
1305 Dantignac St
Augusta, GA 30901-2774
Phone
(706) 823-3807
Fax
(706) 823-3810
NPI assigned
Jan 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2009

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 AT000785 GA Primary

Addresses

Primary practice location

1305 Dantignac St
Augusta, GA 30901-2774

Mailing address

1305 Dantignac St
Augusta, GA 30901-2774
Phone (706) 823-3807

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

LicenseStateTypeSpecialty
AT000785GAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Rehabilitation, Fitness and Performance Center LLC Past Accepting new patients
Peak Rehabilitation, Fitness and Performance Center Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232668800000",
    "number": "1932347333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 DANTIGNAC ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012774",
            "telephone_number": "706-823-3807",
            "fax_number": "706-823-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 DANTIGNAC ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012774",
            "telephone_number": "706-823-3807",
            "fax_number": "706-823-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRILL",
        "first_name": "LESLIE",
        "middle_name": "PAGE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-23",
        "last_updated": "2009-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT000785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; 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.