1. Home
  2. Directory
  3. South Carolina
  4. Conway
  5. Specialist Technologist
  6. NPI Profile

NICKLAS LIDSTROM
NPI 1871369603
Specialist/Technologist - Athletic Trainer in Conway, SC

Active since December 04, 2023
925 ONE LANDON LOOP, CONWAY, SC 29528(843) 349-2825 Get Directions Write a Review

NPPES record last updated: December 4, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Nicklas Lidstrom NPPES

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

NICKLAS LIDSTROM (NPI 1871369603) is an individual athletic trainer provider in Conway, South Carolina, licensed in South Carolina (AT03472) and active in the NPI registry since December 2023.

NPPES Registry Identity

NPI1871369603
Entity TypeIndividualMale
Primary Taxonomy2255A2300X
Provider Legal NameNICKLAS LIDSTROM
Location Address925 ONE LANDON LOOPConway, SC 29528
Mailing Address111 Village Center Blvd Unit 2210Myrtle Beach, SC 29579-6719
Phone(843) 349-2825
Sole ProprietorYes
Enumeration DateDecember 4, 2023
NPPES CertifiedJune 23, 2023
✔ NPI 1871369603 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
License✔ Licensed in SC · AT03472
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.
925 ONE LANDON LOOP, Conway, SC 29528
Open in Google Maps ↗

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 Nicklas Lidstrom's NPI number?

The NPI number for Nicklas Lidstrom is 1871369603. It was assigned to this individual provider in the NPPES registry on December 4, 2023.

Where is Nicklas Lidstrom located?

Nicklas Lidstrom practices at 925 One Landon Loop, Conway, SC 29528. The listed phone number is (843) 349-2825.

What is Nicklas Lidstrom'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 Nicklas Lidstrom was last updated on December 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.