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

Mr. Derek Port, ATC

Individual provider Athletic Trainer · NPI 1487004636

Mr. Derek Port, ATC is an Athletic Trainer in Campbellsville, Kentucky. Practices as a sole proprietor. Licensed in Kentucky.

Licensed in
KY
In the registry since
2016
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

1 University Dr Upo #823
Campbellsville, KY 42718-2190
Phone: (270) 789-5544
Fax: (270) 789-5199
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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 AT512 (KY)

Record details

NPI number1487004636
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC
Sole proprietorYes
NPI enumeratedJune 20, 2016
Last updated in NPPESJune 20, 2016
Mailing address1 University Dr, Upo #823, Campbellsville, KY 42718-2190

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