Individual provider Active NPI

Saisanjana Vattigunta

  • Athletic Trainer
  • Durham, NC
National Provider Identifier
1447707302
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
LAT-3524 Issued in NC
Practice address
3609 SW Durham Dr
Durham, NC 27707-6507
Phone
(919) 471-9622
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 LAT-3524 NC Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3609 SW Durham Dr
Durham, NC 27707-6507

Mailing address

620 Perkins Dr
Chapel Hill, NC 27514-1795
Phone (704) 989-1233

Other practice location 1

6721 Springs Mill Rd
Charlotte, NC 28277-3637
Phone (704) 989-1233

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

LicenseStateTypeSpecialty
LAT-3524NCMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1447707302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 PERKINS DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275141795",
            "telephone_number": "704-989-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 SW DURHAM DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076507",
            "telephone_number": "919-471-9622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6721 Springs Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773637",
            "country_code": "US",
            "telephone_number": "704-989-1233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VATTIGUNTA",
        "first_name": "SAISANJANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-3524",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.