Provider Demographics
NPI:1366160707
Name:SIGMON, TAYLOR JAMES (LAT,ATC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:JAMES
Last Name:SIGMON
Suffix:
Gender:M
Credentials:LAT,ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8112 NW MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:STOKESDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27357-9220
Mailing Address - Country:US
Mailing Address - Phone:336-209-3128
Mailing Address - Fax:
Practice Address - Street 1:1700 LEHMAN RD
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-5246
Practice Address - Country:US
Practice Address - Phone:512-268-8454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT86902255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAT8690OtherATHLETIC TRAINING LICENSE
2000041741OtherCAATE BOARD OF CERTIFICATION FOR ATHLETIC TRAINING