Samantha Davis
Individual provider Active NPI Athletic Trainer · Athens, GA
NPI 1992109136 · NPPES record last updated Aug 25, 2022
Key facts
- NPI
- 1992109136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- AT004054 (GA)
- Practice address
- 1 Selig Cir
Athens, GA 30602-1501 - Phone
- (706) 542-2157
- NPI assigned
- Oct 17, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT004054 | GA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT004054 | GA | Yes |
Addresses
Primary practice location
1 Selig Cir
Athens, GA 30602-1501
Mailing address
PO Box 1472
Athens, GA 30603-1472
Phone (706) 542-2157
Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.