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

Mr. Kermit C Sullivan III, ATC

Individual provider Athletic Trainer · NPI 1124157185

Mr. Kermit C Sullivan III, ATC is an Athletic Trainer in Nampa, Idaho. Practices as a sole proprietor. Licensed in Idaho.

Licensed in
ID
In the registry since
2007
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

1303 E Greenhurst Rd
Nampa, ID 83686-7216
Phone: (208) 468-7820
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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 AT-182 (ID)

Record details

NPI number1124157185
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC
Sole proprietorYes
NPI enumeratedMarch 5, 2007
Last updated in NPPESJuly 8, 2007

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