Active NPI
Annie Plumb, LAT, ATC, MS
- Athletic Trainer
- Malibu, CA
National Provider Identifier
1235816695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000042084
- Practice address
- 24255 Pacific Coast Hwy
Malibu, CA 90263-3999 - Phone
- (402) 517-8488
- NPI assigned
- Jun 28, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | 2000042084 | CA | Primary |
Addresses
Primary practice location
24255 Pacific Coast Hwy
Malibu, CA 90263-3999
Mailing address
24255 Pacific Coast Hwy Dept 5000
Malibu, CA 90263-5000
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000042084 | CA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1235816695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24255 PACIFIC COAST HWY DEPT 5000",
"city": "MALIBU",
"state": "CA",
"postal_code": "902635000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24255 PACIFIC COAST HWY",
"city": "MALIBU",
"state": "CA",
"postal_code": "902633999",
"telephone_number": "402-517-8488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLUMB",
"first_name": "ANNIE",
"credential": "LAT, ATC, MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-28",
"last_updated": "2023-06-28",
"certification_date": "2023-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CA",
"license": "2000042084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malibu, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.