Active NPI
Leeca Nicole Baran
- Athletic Trainer
- Memphis, TN
National Provider Identifier
1972016236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 318191
- Practice address
- 3050 Winchester Rd
Memphis, TN 38118-4860 - Phone
- (901) 224-0135
- NPI assigned
- Nov 8, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | 318191 | TN | Primary |
Addresses
Primary practice location
3050 Winchester Rd
Memphis, TN 38118-4860
Mailing address
9455 Goodman Rd Apt F6
Olive Branch, MS 38654-1718
Other practice location 1
9455 Goodman Rd Apt F6
Olive Branch, MS 38654-1718
Phone (570) 904-9275
Other practice location 2
20 S Hollywood Blvd
Hazleton, PA 18202-8044
Phone (570) 436-6489
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 |
|---|---|---|---|
| 318191 | TN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667174400000",
"number": "1972016236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9455 GOODMAN RD APT F6",
"city": "OLIVE BRANCH",
"state": "MS",
"postal_code": "386541718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3050 WINCHESTER RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381184860",
"telephone_number": "901-224-0135"
}
],
"practiceLocations": [
{
"address_1": "9455 Goodman Rd Apt F6",
"address_purpose": "LOCATION",
"city": "Olive Branch",
"state": "MS",
"postal_code": "386541718",
"country_code": "US",
"telephone_number": "570-904-9275",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "20 S Hollywood Blvd",
"address_purpose": "LOCATION",
"city": "Hazleton",
"state": "PA",
"postal_code": "182028044",
"country_code": "US",
"telephone_number": "570-436-6489",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BARAN",
"first_name": "LEECA",
"middle_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-08",
"last_updated": "2022-10-31",
"certification_date": "2022-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "318191",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.