Individual provider Active NPI

Erin L Rose, ATC

  • Athletic Trainer
  • Pullman, WA
National Provider Identifier
1265049902
Registry record updated Sep 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
A160976844 Issued in WA
Practice address
510 NW Larry St
Pullman, WA 99163-3584
Phone
(509) 332-1551
NPI assigned
Sep 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2020

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 A160976844 WA Primary

Addresses

Primary practice location

510 NW Larry St
Pullman, WA 99163-3584

Mailing address

512 Britton LN
Moscow, ID 83843-8801
Phone (209) 418-9543

Other names 1

  • Erin L Godde Former name

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
A160976844WAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1601164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601164800000",
    "number": "1265049902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 BRITTON LN",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838438801",
            "telephone_number": "209-418-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 NW LARRY ST",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991633584",
            "telephone_number": "509-332-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ERIN",
        "middle_name": "L",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-27",
        "last_updated": "2020-09-27",
        "certification_date": "2020-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A160976844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "GODDE",
            "middle_name": "L",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pullman, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2020; 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.