Active NPI
Daryl Nelson
- Athletic Trainer
- Louisville, KY
National Provider Identifier
1942696414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1148
- Practice address
- 2800 S Floyd St
Louisville, KY 40209-1818 - Phone
- (602) 818-1613
- NPI assigned
- Apr 12, 2015
- 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 | 1148 | KY | Primary |
Addresses
Primary practice location
2800 S Floyd St
Louisville, KY 40209-1818
Mailing address
7415 Steeplecrest Cir
Apt 302
Louisville, KY 40222-9084
Phone (602) 818-1613
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 |
|---|---|---|---|
| 1148 | KY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428796800000",
"number": "1942696414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7415 STEEPLECREST CIR",
"address_2": "APT 302",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402229084",
"telephone_number": "602-818-1613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 S FLOYD ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402091818",
"telephone_number": "602-818-1613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "DARYL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-04-12",
"last_updated": "2015-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "KY",
"license": "1148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.