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

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

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