Active NPI
Shelli Lee Green, LAT, ATC
- Athletic Trainer
- Marshall, MN
National Provider Identifier
1275720187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2021
- Practice address
- 1501 State St
Marshall, MN 56258-3306 - Phone
- (507) 537-6297
- Fax
- (507) 537-6578
- NPI assigned
- Sep 25, 2007
- 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 | 2021 | MN | Primary |
Addresses
Primary practice location
1501 State St
Marshall, MN 56258-3306
Mailing address
1501 State St
Marshall, MN 56258-3306
Phone (507) 537-6297
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 |
|---|---|---|---|
| 2021 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190678400000",
"number": "1275720187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 STATE ST",
"city": "MARSHALL",
"state": "MN",
"postal_code": "562583306",
"telephone_number": "507-537-6297",
"fax_number": "507-537-6578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 STATE ST",
"city": "MARSHALL",
"state": "MN",
"postal_code": "562583306",
"telephone_number": "507-537-6297",
"fax_number": "507-537-6578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "SHELLI",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-25",
"last_updated": "2007-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "2021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marshall, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.