Active NPI
Katherine Salanga
- Athletic Trainer
- Bloomington, IL
National Provider Identifier
1295248979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096.004770
- Practice address
- 135 N Williamsburg Dr
Bloomington, IL 61704-3528 - Phone
- (309) 664-9104
- NPI assigned
- Nov 16, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | 096.004770 | IL | Primary |
Addresses
Primary practice location
135 N Williamsburg Dr
Bloomington, IL 61704-3528
Mailing address
223 Kalamazoo St
East Lansing, MI 48824-5400
Other practice location 1
223 Kalamazoo St
East Lansing, MI 48824-5400
Phone (517) 355-1627
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 |
|---|---|---|---|
| 096.004770 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600128000000",
"number": "1295248979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223 KALAMAZOO ST",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488245400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 N WILLIAMSBURG DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617043528",
"telephone_number": "309-664-9104"
}
],
"practiceLocations": [
{
"address_1": "223 Kalamazoo St",
"address_purpose": "LOCATION",
"city": "East Lansing",
"state": "MI",
"postal_code": "488245400",
"country_code": "US",
"telephone_number": "517-355-1627",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SALANGA",
"first_name": "KATHERINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-16",
"last_updated": "2020-09-15",
"certification_date": "2020-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096.004770",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.