Angelo Bongiorno, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2014028839 Issued in MO

Practice address

1 University Blvd
Saint Louis, MO 63121-4400

Phone

(314) 516-5686

NPI assigned

Sep 15, 2014

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

State licenses

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1295136893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631214400",
            "telephone_number": "314-516-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631214400",
            "telephone_number": "314-516-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONGIORNO",
        "first_name": "ANGELO",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-15",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2014028839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Bone, PHARMD
• David E. Bone, D.C
• Laura K Bonebrake, M.D.
• Michael Llewellyn Bonebrake, MD
• Jacquelyn Ann Bongard, OD
• Christian William Bongiorno, DO
• Shalini Bongu, M.D.
• Annie Grace Bonis, DDS
• Carmel F Bonnaig, MD
• Ashley Bonner, LCSW

• Athletic Trainer in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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.