Individual provider Active NPI

Susan R Cross, M.S., LATC

  • Athletic Trainer
  • Saint Leo, FL
National Provider Identifier
1306368386
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
FL3905 Issued in FL
Practice address
33701 St Rd 52
Saint Leo, FL 33574
Phone
(352) 588-7557
NPI assigned
Jul 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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 FL3905 FL Primary

Addresses

Primary practice location

33701 St Rd 52
Saint Leo, FL 33574

Mailing address

33701 St Rd 52
MSC 2038
Saint Leo, FL 33603

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
FL3905FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1306368386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33701 ST RD 52",
            "address_2": "MSC 2038",
            "city": "SAINT LEO",
            "state": "FL",
            "postal_code": "33603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33701 ST RD 52",
            "city": "SAINT LEO",
            "state": "FL",
            "postal_code": "33574",
            "telephone_number": "352-588-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSS",
        "first_name": "SUSAN",
        "middle_name": "R",
        "credential": "M.S., LATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "FL3905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Leo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; 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.