Individual provider Active NPI

Mark Sayer Avena

  • Athletic Trainer
  • Spokane Valley, WA
National Provider Identifier
1174096630
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
17614 E Broadway Ave
Spokane Valley, WA 99016-8532
Phone
(509) 499-4931
NPI assigned
Jan 8, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193400000X SINGLE SPECIALTY GROUP 2255A2300X WA Primary

Addresses

Primary practice location

17614 E Broadway Ave
Spokane Valley, WA 99016-8532

Mailing address

17614 E Broadway Ave
Spokane Valley, WA 99016-8532
Phone (509) 499-4931

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

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1174096630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17614 E BROADWAY AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990168532",
            "telephone_number": "509-499-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17614 E BROADWAY AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990168532",
            "telephone_number": "509-499-4931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVENA",
        "first_name": "MARK",
        "middle_name": "SAYER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

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

Verify at the official NPI Registry.