Shirley Ann Imber, AT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT006181 Issued in OH

Practice address

5680 Venture Dr
Dublin, OH 43017-2190

Phone

(614) 355-8778

NPI assigned

Mar 9, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shirley Ann Tomten Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1174064299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 VENTURE DR",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430172190",
            "telephone_number": "614-355-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5680 VENTURE DR",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430172190",
            "telephone_number": "614-355-8778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Butterfly Gardens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154985",
            "country_code": "US",
            "telephone_number": "614-355-8778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMBER",
        "first_name": "SHIRLEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "AT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT006181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRLEY",
            "last_name": "TOMTEN",
            "middle_name": "ANN",
            "credential": "AT, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Athletic Trainer in Dublin, OH
• Providers in Dublin, OH by specialty
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.