Individual provider Active NPI

Quinn Marianno

  • Athletic Trainer
  • Spokane, WA
National Provider Identifier
1134622137
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT-513 Issued in ID
Practice address
605 E Holland Ave Ste 112
Spokane, WA 99218-1246
Phone
(509) 342-3251
Fax
(509) 342-3280
NPI assigned
Mar 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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-513 ID Primary

Addresses

Primary practice location

605 E Holland Ave Ste 112
Spokane, WA 99218-1246

Mailing address

605 E Holland Ave Ste 112
Spokane, WA 99218-1246
Phone (509) 342-3251

Other practice location 1

1000 W Garden Ave
Coeur D Alene, ID 83814-2161
Phone (208) 819-0633

Other identifiers 1

IdentifierTypeStateIssuer
160151292OtherIDREGENCE

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-513IDMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1134622137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 E HOLLAND AVE STE 112",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181246",
            "telephone_number": "509-342-3251",
            "fax_number": "509-342-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 E HOLLAND AVE STE 112",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181246",
            "telephone_number": "509-342-3251",
            "fax_number": "509-342-3280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Garden Ave",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142161",
            "country_code": "US",
            "telephone_number": "208-819-0633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARIANNO",
        "first_name": "QUINN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-15",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ID",
            "license": "AT-513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "160151292",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.

Verify at the official NPI Registry.