Active NPI
Shawn L McDermott, ATC
- Athletic Trainer
- Palm Harbor, FL
National Provider Identifier
1942428198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL2260
- Practice address
- 4894 Inverness CT Apt 102
Palm Harbor, FL 34685-4102 - Phone
- (727) 641-8987
- NPI assigned
- Apr 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | AL2260 | FL | Primary |
Addresses
Primary practice location
4894 Inverness CT Apt 102
Palm Harbor, FL 34685-4102
Mailing address
4894 Inverness CT Apt 102
Palm Harbor, FL 34685-4102
Phone (727) 641-8987
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AL2260 | Other | FL | ATHLETIC TRAINER |
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 |
|---|---|---|---|
| AL2260 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942428198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4894 INVERNESS CT APT 102",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346854102",
"telephone_number": "727-641-8987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4894 INVERNESS CT APT 102",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346854102",
"telephone_number": "727-641-8987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDERMOTT",
"first_name": "SHAWN",
"middle_name": "L",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL2260",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATHLETIC TRAINER",
"identifier": "AL2260",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Harbor, FL
Sources for this page
- 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.