Individual provider Active NPI

Marissa Yorgey, LAT, ATC

  • Athletic Trainer
  • Terre Haute, IN
National Provider Identifier
1194104349
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
36002250A Issued in IN
Practice address
377 Antioch Cir W
Terre Haute, IN 47803-9453
Phone
(641) 220-0872
NPI assigned
May 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

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 36002250A IN Primary

Addresses

Primary practice location

377 Antioch Cir W
Terre Haute, IN 47803-9453

Mailing address

377 Antioch Cir W
Terre Haute, IN 47803-9453
Phone (641) 220-0872

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
36002250AINMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1194104349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 ANTIOCH CIR W",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478039453",
            "telephone_number": "641-220-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 ANTIOCH CIR W",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478039453",
            "telephone_number": "641-220-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YORGEY",
        "first_name": "MARISSA",
        "name_prefix": "Ms.",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36002250A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.