Individual provider Active NPI

Joel Saulsberry, MS, ATC, LAT

  • Athletic Trainer
  • Lees Summit, MO
National Provider Identifier
1417317579
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2011005786 Issued in MO
Practice address
600 NW Murray Rd
Suite 112
Lees Summit, MO 64081-1204
Phone
(816) 282-5985
Fax
(816) 282-5988
NPI assigned
Mar 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2011005786 MO Primary
Athletic Trainer 2255A2300X 24-00510 KS

Addresses

Primary practice location

600 NW Murray Rd
Suite 112
Lees Summit, MO 64081-1204

Mailing address

2100 SE Blue Pkwy
Lees Summit, MO 64063-1007
Phone (816) 282-5985

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
24-00510KSMDAthletic Trainer
2011005786MOMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1417317579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 SE BLUE PKWY",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640631007",
            "telephone_number": "816-282-5985",
            "fax_number": "816-282-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NW MURRAY RD",
            "address_2": "SUITE 112",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640811204",
            "telephone_number": "816-282-5985",
            "fax_number": "816-282-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAULSBERRY",
        "first_name": "JOEL",
        "credential": "MS, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2011005786",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "24-00510",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; 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.