Active NPI
Tiffany Lyn Lebengood, MS, ATC
- Athletic Trainer
- Lewisburg, PA
National Provider Identifier
1952484669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT002024A
- Practice address
- Moore Avenue
Bucknell University - Klarc
Lewisburg, PA 17837 - Phone
- (570) 577-3049
- Fax
- (570) 577-1660
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- No
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 | RT002024A | PA | Primary |
Addresses
Primary practice location
Moore Avenue
Bucknell University - Klarc
Lewisburg, PA 17837
Mailing address
410 N 4TH St
Lewisburg, PA 17837-1106
Phone (570) 523-0890
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT002024A | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952484669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 N 4TH ST",
"city": "LEWISBURG",
"state": "PA",
"postal_code": "178371106",
"telephone_number": "570-523-0890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MOORE AVENUE",
"address_2": "BUCKNELL UNIVERSITY - KLARC",
"city": "LEWISBURG",
"state": "PA",
"postal_code": "17837",
"telephone_number": "570-577-3049",
"fax_number": "570-577-1660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEBENGOOD",
"first_name": "TIFFANY",
"middle_name": "LYN",
"name_prefix": "Miss",
"credential": "MS, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT002024A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewisburg, PA
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.