Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenneth Shaw, ATC, LAT

Individual provider Athletic Trainer · NPI 1891417580

Kenneth Shaw, ATC, LAT is an Athletic Trainer in Bristol, Tennessee. Licensed in Tennessee. Registered with an NPI since 2022.

Licensed in
TN
In the registry since
2022
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

1350 King College Rd
Bristol, TN 37620-2632
Phone: (800) 362-0014
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2994 (TN)

Record details

NPI number1891417580
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC , LAT
Sole proprietorNo
NPI enumeratedSeptember 19, 2022
Last updated in NPPESSeptember 19, 2022
Certification dateSeptember 16, 2022
Mailing address362 Grandview St, Church Hill, TN 37642-3828

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