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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

RYAN BLAKE PRIDEMORE, LAT, ATC

Active

RYAN BLAKE PRIDEMORE, LAT, ATC is a Athletic Trainer healthcare provider located in LAS CRUCES, New Mexico. NPI 1033895602 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · LAS CRUCES, NM

Registration Details

NPI Number
1033895602
Provider Type
Individual
Gender
Male
NPI Issued
Jun 27, 2023 (3.0937947189408 yrs)
Last Updated
Jun 10, 2025
Licenses
AT-2024-0006 (NM)
AT9424 (TX)

Practice Information

Address
5700 MESA GRANDE DR
LAS CRUCES, NM, 880116017
Browse NM providers · Browse ZIP 88011
Phone
4233121031
Primary Specialty
Athletic Trainer
2255A2300X
Additional Specialty
Athletic Trainer

Other Athletic Trainer Providers in LAS CRUCES, NM

Name Credential NPI
ANDY SCOTT KRENTZ ATC, LAT 1083658876
MS. KIM S. O'CONNELL-BROCK ATC 1437262185
JAMES LE ROY SCHAPEKAHM A.T.C., LAT 1730222506
MICHAEL J O'LAREY ATC 1013050012
MR. DARYL C WOOTEN A.T.C. 1316072317
KIMBERLY HERBERT M.S., ATC 1780860049
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.