Active NPI
Amber Rose Suckow, ATC
- Athletic Trainer
- Fredericksburg, IA
National Provider Identifier
1326248402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0711
- Practice address
- 2865 Newell Ave
Fredericksburg, IA 50630-9515 - Phone
- (480) 751-8368
- NPI assigned
- Jul 18, 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 | 0711 | AZ | Primary |
Addresses
Primary practice location
2865 Newell Ave
Fredericksburg, IA 50630-9515
Mailing address
2865 Newell Ave
Fredericksburg, IA 50630-9515
Phone (480) 751-8368
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": "1184716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184803200000",
"number": "1326248402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2865 NEWELL AVE",
"city": "FREDERICKSBURG",
"state": "IA",
"postal_code": "506309515",
"telephone_number": "480-751-8368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2865 NEWELL AVE",
"city": "FREDERICKSBURG",
"state": "IA",
"postal_code": "506309515",
"telephone_number": "480-751-8368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUCKOW",
"first_name": "AMBER",
"middle_name": "ROSE",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-18",
"last_updated": "2007-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AZ",
"license": "0711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.