Active NPI
Avery Austin
- Athletic Trainer
- Ellensburg, WA
National Provider Identifier
1265025381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 61567912
- Practice address
- 400 E University Way
Ellensburg, WA 98926-7500 - Phone
- (509) 307-2820
- NPI assigned
- Feb 19, 2021
- 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 | 61567912 | WA | Primary |
Addresses
Primary practice location
400 E University Way
Ellensburg, WA 98926-7500
Mailing address
204 Bel Air Dr
Yakima, WA 98908-3304
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
| License | State | Type | Specialty |
|---|---|---|---|
| 61567912 | WA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733702400000",
"number": "1265025381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 BEL AIR DR",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989083304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E UNIVERSITY WAY",
"city": "ELLENSBURG",
"state": "WA",
"postal_code": "989267500",
"telephone_number": "509-307-2820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUSTIN",
"first_name": "AVERY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-19",
"last_updated": "2024-12-09",
"certification_date": "2024-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WA",
"license": "61567912",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellensburg, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.