Individual provider Active NPI

Elizabeth Anna Fleissner, ATCR

  • Athletic Trainer
  • Duluth, MN
National Provider Identifier
1164579561
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2255A2300X Issued in MN
Practice address
3515 Chambersburg Ave
Duluth, MN 55811-3046
Phone
(218) 722-5218
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2255A2300X MN Primary

Addresses

Primary practice location

3515 Chambersburg Ave
Duluth, MN 55811-3046

Mailing address

3515 Chambersburg Ave
Duluth, MN 55811-3046
Phone (218) 722-5218

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
2255A2300XMNMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164579561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 CHAMBERSBURG AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558113046",
            "telephone_number": "218-722-5218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 CHAMBERSBURG AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558113046",
            "telephone_number": "218-722-5218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEISSNER",
        "first_name": "ELIZABETH",
        "middle_name": "ANNA",
        "name_prefix": "Ms.",
        "credential": "ATCR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "2255A2300X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.