Anna Carol Porter Simpson, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT002617 Issued in GA

Practice address

8225 Mall Pkwy Ste 150
Lithonia, GA 30038-7103

Phone

(863) 221-2620

NPI assigned

Jul 9, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Anna Carol Porter Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614470400000",
    "number": "1972919074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4680 MATTHEWS PARK DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300397100",
            "telephone_number": "863-221-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8225 MALL PKWY STE 150",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300387103",
            "telephone_number": "863-221-2620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 E College Ave",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300303770",
            "country_code": "US",
            "telephone_number": "863-221-2620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "ANNA",
        "middle_name": "CAROL PORTER",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2021-02-28",
        "certification_date": "2021-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KY",
            "license": "AT979",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT002617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "PORTER",
            "middle_name": "CAROL",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Athletic Trainer in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.