Active NPI
Cydney Shanks, LAT, ATC
- Athletic Trainer
- Baraboo, WI
National Provider Identifier
1154967446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2429-39
- Practice address
- 707 14TH St
Baraboo, WI 53913-1539 - Phone
- (608) 356-1480
- NPI assigned
- Nov 21, 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 110063 | IA | |
| Athletic Trainer | 2255A2300X | 2429-39 | WI | Primary |
Addresses
Primary practice location
707 14TH St
Baraboo, WI 53913-1539
Mailing address
212 Madison St
Sauk City, WI 53583-1024
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 |
|---|---|---|---|
| 110063 | IA | MD | Athletic Trainer |
| 2429-39 | WI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1154967446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 MADISON ST",
"city": "SAUK CITY",
"state": "WI",
"postal_code": "535831024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 14TH ST",
"city": "BARABOO",
"state": "WI",
"postal_code": "539131539",
"telephone_number": "608-356-1480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANKS",
"first_name": "CYDNEY",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-21",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IA",
"license": "110063",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "2429-39",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baraboo, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.