Active NPI
Elizabeth Amy Wilson, ATC
- Athletic Trainer
- Eugene, OR
National Provider Identifier
1003004193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1240 University of Oregon
122 Esslinger
Eugene, OR 97403-1205 - Phone
- (541) 346-4107
- NPI assigned
- Oct 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | OR | Primary |
Addresses
Primary practice location
1240 University of Oregon
122 Esslinger
Eugene, OR 97403-1205
Mailing address
3355 Loma Linda Dr
Eugene, OR 97405-2791
Phone (717) 343-9501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070402698 | OR | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192406400000",
"number": "1003004193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3355 LOMA LINDA DR",
"city": "EUGENE",
"state": "OR",
"postal_code": "974052791",
"telephone_number": "717-343-9501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1240 UNIVERSITY OF OREGON",
"address_2": "122 ESSLINGER",
"city": "EUGENE",
"state": "OR",
"postal_code": "974031205",
"telephone_number": "541-346-4107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ELIZABETH",
"middle_name": "AMY",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-15",
"last_updated": "2007-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.