Active NPI
Stacey Gaven, PHD, ATC, LAT
- Athletic Trainer
- Franklin, IN
National Provider Identifier
1437529674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36002199A
- Practice address
- 101 Branigin Blvd
Spurlock 213
Franklin, IN 46131-2598 - Phone
- (317) 738-8123
- Fax
- (317) 738-8248
- NPI assigned
- Sep 30, 2015
- 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 | 36002199A | IN | Primary |
Addresses
Primary practice location
101 Branigin Blvd
Spurlock 213
Franklin, IN 46131-2598
Mailing address
1192 Balaton LN
208
Greenwood, IN 46143-8019
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36002199A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443571200000",
"number": "1437529674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1192 BALATON LN",
"address_2": "208",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461438019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BRANIGIN BLVD",
"address_2": "SPURLOCK 213",
"city": "FRANKLIN",
"state": "IN",
"postal_code": "461312598",
"telephone_number": "317-738-8123",
"fax_number": "317-738-8248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAVEN",
"first_name": "STACEY",
"credential": "PHD, ATC, LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-30",
"last_updated": "2015-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36002199A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Franklin, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.