Active NPI
Kengo Sugimoto, ATC
- Athletic Trainer
- Lincoln, NE
National Provider Identifier
1033616529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1400 R St
Lincoln, NE 68588-0007 - Phone
- (402) 472-4224
- NPI assigned
- Apr 10, 2018
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
1400 R St
Lincoln, NE 68588-0007
Mailing address
4867 Gibbs Ave
Boulder, CO 80301-6207
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525132800000",
"number": "1033616529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4867 GIBBS AVE",
"city": "BOULDER",
"state": "CO",
"postal_code": "803016207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 R ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685880007",
"telephone_number": "402-472-4224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUGIMOTO",
"first_name": "KENGO",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-10",
"last_updated": "2018-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.