Active NPI
William David Ivens, M.S., ATC
- Athletic Trainer
- Alcoa, TN
National Provider Identifier
1962828798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1293
- Practice address
- 220 Associates Blvd
Alcoa, TN 37701-1943 - Phone
- (865) 980-7140
- NPI assigned
- Mar 18, 2014
- 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 | 1293 | TN | Primary |
Addresses
Primary practice location
220 Associates Blvd
Alcoa, TN 37701-1943
Mailing address
3250 Sevierville Rd
Maryville, TN 37804-2303
Phone (865) 789-4523
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 |
|---|---|---|---|
| 1293 | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395100800000",
"number": "1962828798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3250 SEVIERVILLE RD",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378042303",
"telephone_number": "865-789-4523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 ASSOCIATES BLVD",
"city": "ALCOA",
"state": "TN",
"postal_code": "377011943",
"telephone_number": "865-980-7140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVENS",
"first_name": "WILLIAM",
"middle_name": "DAVID",
"credential": "M.S., ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-03-18",
"last_updated": "2014-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "1293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alcoa, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.