Active NPI
Suzanne Siebert
- Athletic Trainer
- Melbourne, FL
National Provider Identifier
1083200323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 3421 Beth LN
Melbourne, FL 32934-8416 - Phone
- (321) 610-3003
- NPI assigned
- Dec 20, 2020
- Sex
- Female
- Sole proprietor
- Yes
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
3421 Beth LN
Melbourne, FL 32934-8416
Mailing address
3421 Beth LN
Melbourne, FL 32934-8416
Phone (321) 610-3003
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": "1608422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608422400000",
"number": "1083200323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3421 BETH LN",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329348416",
"telephone_number": "321-610-3003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3421 BETH LN",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329348416",
"telephone_number": "321-610-3003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEBERT",
"first_name": "SUZANNE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-20",
"last_updated": "2020-12-20",
"certification_date": "2020-12-20",
"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 Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.