Active NPI
Gabrielle Langerud
- Athletic Trainer
- Bloomington, IN
National Provider Identifier
1053972208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36003604A
- Practice address
- 1001 E 17TH St
Bloomington, IN 47408-1590 - Phone
- (320) 493-3783
- NPI assigned
- Jun 27, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | 36003604A | IN | Primary |
Addresses
Primary practice location
1001 E 17TH St
Bloomington, IN 47408-1590
Mailing address
21878 Forest Hill Rd
Richmond, MN 56368-8315
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 |
|---|---|---|---|
| 36003604A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693958400000",
"number": "1053972208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21878 FOREST HILL RD",
"city": "RICHMOND",
"state": "MN",
"postal_code": "563688315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 E 17TH ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474081590",
"telephone_number": "320-493-3783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGERUD",
"first_name": "GABRIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-27",
"last_updated": "2023-09-06",
"certification_date": "2023-09-06",
"status": "A"
},
"taxonomies": [
{
"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": "IN",
"license": "36003604A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.