Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

TOMMY SOURIYAVONG ATC,LAT
NPI 1477487221
Specialist/Technologist - Athletic Trainer in Old Forge, PA

Q: What is Tommy Souriyavong's NPI number?

The NPI number for Tommy Souriyavong is 1477487221. It was assigned to this individual provider in the NPPES registry on June 9, 2026.

Q: What is Tommy Souriyavong's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

Q: When was this NPI record last updated?

The NPPES record for Tommy Souriyavong was last updated on June 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 09, 2026

110 BUBERNAK BLVD, OLD FORGE, PA 18518(570) 540-1178 Get Directions Write a Review

NPPES record added: June 9, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Tommy Souriyavong Atc,lat NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TOMMY SOURIYAVONG ATC,LAT (NPI 1477487221) is an individual athletic trainer provider in Old Forge, Pennsylvania and active in the NPI registry since June 2026.

NPPES Registry Identity

NPI1477487221

Entity TypeIndividualMale

Primary Taxonomy2255A2300X

Provider Legal NameTOMMY SOURIYAVONGCredential: ATC,LAT

Location Address110 BUBERNAK BLVDOld Forge, PA 18518-1021

Mailing Address110 Bubernak BlvdOld Forge, PA 18518-1021 · (570) 540-1178

Phone(570) 540-1178

Sole ProprietorNo

Enumeration DateJune 9, 2026

NPPES CertifiedJune 9, 2026

✔ NPI 1477487221 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2255A2300X

Definition

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

110 BUBERNAK BLVD, Old Forge, PA 18518

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tommy Souriyavong's NPI number?

The NPI number for Tommy Souriyavong is 1477487221. It was assigned to this individual provider in the NPPES registry on June 9, 2026.

Where is Tommy Souriyavong located?

Tommy Souriyavong practices at 110 Bubernak Blvd, Old Forge, PA 18518. The listed phone number is (570) 540-1178.

What is Tommy Souriyavong's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

When was this NPI record last updated?

The NPPES record for Tommy Souriyavong was last updated on June 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.