Active NPI
Andrea Vavra, ATC
- Athletic Trainer
- Bloomington, MN
National Provider Identifier
1295111979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2362
- Practice address
- 8100 Northland Dr
Bloomington, MN 55431-4800 - Phone
- (952) 866-5660
- NPI assigned
- Aug 5, 2015
- 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 | 2362 | MN | Primary |
Addresses
Primary practice location
8100 Northland Dr
Bloomington, MN 55431-4800
Mailing address
8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 806-5660
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463011200000",
"number": "1295111979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8100 NORTHLAND DR",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554314800",
"telephone_number": "952-806-5660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8100 NORTHLAND DR",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554314800",
"telephone_number": "952-866-5660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAVRA",
"first_name": "ANDREA",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-05",
"last_updated": "2016-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "2362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.