Active NPI
Amanda Nichole Fenton
- Athletic Trainer
- Naperville, IL
National Provider Identifier
1003471194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- F535-0149-7743-00
- Practice address
- 2420 High Meadow Rd
Naperville, IL 60564-5375 - Phone
- (630) 699-3341
- NPI assigned
- May 5, 2019
- 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 | F535-0149-7743-00 | WI | Primary |
Addresses
Primary practice location
2420 High Meadow Rd
Naperville, IL 60564-5375
Mailing address
2420 High Meadow Rd
Naperville, IL 60564-5375
Phone (630) 699-3341
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 |
|---|---|---|---|
| F535-0149-7743-00 | WI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557014400000",
"number": "1003471194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2420 HIGH MEADOW RD",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605645375",
"telephone_number": "630-699-3341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2420 HIGH MEADOW RD",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605645375",
"telephone_number": "630-699-3341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENTON",
"first_name": "AMANDA",
"middle_name": "NICHOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-05",
"last_updated": "2019-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "F535-0149-7743-00",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.