Individual provider Active NPI

Shelby Bley, LAT, ATC

  • Athletic Trainer
  • Pueblo, CO
National Provider Identifier
1023667268
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT.0000578 Issued in CO
Practice address
1050 35TH LN
Pueblo, CO 81006-9426
Phone
(719) 948-3351
NPI assigned
Sep 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT.0000578 CO Primary

Addresses

Primary practice location

1050 35TH LN
Pueblo, CO 81006-9426

Mailing address

2726 Atlanta Ave
Pueblo, CO 81003-1341
Phone (719) 251-3631

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

LicenseStateTypeSpecialty
AT.0000578COMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1023667268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2726 ATLANTA AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810031341",
            "telephone_number": "719-251-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 35TH LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810069426",
            "telephone_number": "719-948-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEY",
        "first_name": "SHELBY",
        "name_prefix": "Ms.",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CO",
            "license": "AT.0000578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.

Verify at the official NPI Registry.