Tanner Spoden

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

1781 Kennsington LN
Crystal Lake, IL 60014-2051

Phone

(815) 353-5091

NPI assigned

Feb 8, 2017

Last updated

May 17, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1326586538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1781 KENNSINGTON LN",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600142051",
            "telephone_number": "815-353-5091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 KENNSINGTON LN",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600142051",
            "telephone_number": "815-353-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPODEN",
        "first_name": "TANNER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-08",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriella Spagnola
• Janice Spangler, PSYD
• Michelle Sparrow, FNP-C
• Speech With Mrs Chris LLC
• Lisa Kay Spoden, COTA/L
• Lamont Mark Sprague, O.D.
• Darlene Ann Springer, L.C.P.C.
• Springs at Crystal Lake, LLC (The Springs at Crystal Lake)
• Cari Amber Sprott
• Katelyn St Martin, PA-C

• Athletic Trainer in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; 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.