Seth Ellanson

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

29 Catherine LN
Lake Crystal, MN 56055-2015

Phone

(507) 995-7794

NPI assigned

Apr 22, 2016

Last updated

Apr 22, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1245684513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 CATHERINE LN",
            "city": "LAKE CRYSTAL",
            "state": "MN",
            "postal_code": "560552015",
            "telephone_number": "507-995-7794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 CATHERINE LN",
            "city": "LAKE CRYSTAL",
            "state": "MN",
            "postal_code": "560552015",
            "telephone_number": "507-995-7794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLANSON",
        "first_name": "SETH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Lake Crystal, MN
• Providers in Lake Crystal, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; 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.