Active NPI
Nicholas Spangler, DAT LAT ATC
- Athletic Trainer
- Munster, IN
National Provider Identifier
1164819470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36002615A
- Practice address
- 9042 Columbia Ave
Munster, IN 46321-2927 - Phone
- (219) 836-4461
- NPI assigned
- Apr 24, 2015
- Last updated
- Jul 23, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 36002615A | IN | Primary |
Addresses
Primary practice location
9042 Columbia Ave
Munster, IN 46321-2927
Mailing address
10163 Olcott Ave
Saint John, IN 46373-9539
Phone (219) 798-6850
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 |
|---|---|---|---|
| 36002615A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563840000000",
"number": "1164819470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10163 OLCOTT AVE",
"city": "SAINT JOHN",
"state": "IN",
"postal_code": "463739539",
"telephone_number": "219-798-6850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9042 COLUMBIA AVE",
"city": "MUNSTER",
"state": "IN",
"postal_code": "463212927",
"telephone_number": "219-836-4461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPANGLER",
"first_name": "NICHOLAS",
"credential": "DAT LAT ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-24",
"last_updated": "2019-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36002615A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Munster, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.