Anna Smith, MS, AT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096002537 Issued in IL

Practice address

639 38TH St
Rock Island, IL 61201-2210

Phone

(309) 794-8794

NPI assigned

Jan 2, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1164061545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 COVENTRY CIR",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431304173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 38TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612012210",
            "telephone_number": "309-794-8794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANNA",
        "credential": "MS, AT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT002785",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096002537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney Keith Simmer, D.C.
• Amanda Skelton
• Gabriella Sloan
• Victoria Smeaton, RN
• Adam Smith, OTR/L
• Gina Smith, MSW
• Kathryn Rita Smith, MPH
• Nicole Marie Sodawasser, LCSW
• Daisy Linette Sohn
• Bing-Wen Soong

• Athletic Trainer in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.

Verify at the official NPI Registry.