Active NPI
Courtney Van Damme
- Athletic Trainer
- Mesa, AZ
National Provider Identifier
1396233417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- ATR-009098
- Practice address
- 6745 E Superstition Springs Blvd Apt 2115
Mesa, AZ 85206-4320 - Phone
- (920) 279-4730
- NPI assigned
- Apr 24, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | ATR-009098 | AZ | Primary |
Addresses
Primary practice location
6745 E Superstition Springs Blvd Apt 2115
Mesa, AZ 85206-4320
Mailing address
6745 E Superstition Springs Blvd Apt 2115
Mesa, AZ 85206-4320
Phone (920) 279-4730
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 |
|---|---|---|---|
| ATR-009098 | AZ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575849600000",
"number": "1396233417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6745 E SUPERSTITION SPRINGS BLVD APT 2115",
"city": "MESA",
"state": "AZ",
"postal_code": "852064320",
"telephone_number": "920-279-4730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6745 E SUPERSTITION SPRINGS BLVD APT 2115",
"city": "MESA",
"state": "AZ",
"postal_code": "852064320",
"telephone_number": "920-279-4730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN DAMME",
"first_name": "COURTNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-24",
"last_updated": "2019-12-09",
"certification_date": "2019-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AZ",
"license": "ATR-009098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.