Active NPI
Chelsea L Harrison
- Athletic Trainer
- Fort Wayne, IN
National Provider Identifier
1003448671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2601002641
- Practice address
- 6716 Ramblewood CT Apt L
Fort Wayne, IN 46835-1760 - Phone
- (269) 303-4473
- NPI assigned
- Feb 11, 2020
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | 2601002641 | MI | Primary |
Addresses
Primary practice location
6716 Ramblewood CT Apt L
Fort Wayne, IN 46835-1760
Mailing address
02925 38 50TH St.
Bloomingdale, MI 49026
Phone (269) 303-4473
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 |
|---|---|---|---|
| 2601002641 | MI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683590400000",
"number": "1003448671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "02925 38 50TH ST.",
"city": "BLOOMINGDALE",
"state": "MI",
"postal_code": "49026",
"telephone_number": "269-303-4473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6716 RAMBLEWOOD CT APT L",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468351760",
"telephone_number": "269-303-4473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "CHELSEA",
"middle_name": "L",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-11",
"last_updated": "2023-05-09",
"certification_date": "2023-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": "2601002641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.