Active NPI
Evan Sanders
- Athletic Trainer
- Columbia, MO
National Provider Identifier
1417861964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2025033886
- Practice address
- 3301 Berrywood Dr Ste 204
Columbia, MO 65201-6517 - Phone
- (573) 449-8771
- NPI assigned
- Oct 1, 2026
- Last updated
- Oct 1, 2026
- Sex
- Male
- 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 | 2025033886 | MO | Primary |
Addresses
Primary practice location
3301 Berrywood Dr Ste 204
Columbia, MO 65201-6517
Mailing address
3301 Berrywood Dr Ste 204
Columbia, MO 65201-6517
Phone (573) 449-8771
Other practice location 1
1104 N Providence Rd
Columbia, MO 65203-4398
Phone (573) 214-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790812800000",
"number": "1417861964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3301 BERRYWOOD DR STE 204",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652016517",
"telephone_number": "573-449-8771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 BERRYWOOD DR STE 204",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652016517",
"telephone_number": "573-449-8771"
}
],
"practiceLocations": [
{
"address_1": "1104 N Providence Rd",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "MO",
"postal_code": "652034398",
"country_code": "US",
"telephone_number": "573-214-3000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANDERS",
"first_name": "EVAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-10-01",
"last_updated": "2026-10-01",
"certification_date": "2026-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MO",
"license": "2025033886",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.