Julie Mae Goodmundson, ATR

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1956 Issued in MN

Practice address

17309 Bay Cir
Wayzata, MN 55391-2806

Phone

(612) 636-2936

NPI assigned

May 19, 2007

Sex

Female

Sole proprietor

No

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": "1179532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1356559629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17309 BAY CIR",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553912806",
            "telephone_number": "612-636-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17309 BAY CIR",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553912806",
            "telephone_number": "612-636-2936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3955 119th Ave NW Apt 317",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554336755",
            "country_code": "US",
            "telephone_number": "612-636-2936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODMUNDSON",
        "first_name": "JULIE",
        "middle_name": "MAE",
        "credential": "ATR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "1956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Wayzata, MN
• Providers in Wayzata, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.