Sarah Marlene Shade, ATC, NREMT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT006365 Issued in OH

Practice address

2940 S 2300 E
Millcreek, UT 84109-1924

Phone

(614) 600-4392

NPI assigned

Apr 2, 2020

Last updated

Mar 24, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1467081588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 S 2300 E",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841091924",
            "telephone_number": "614-600-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 S 2300 E",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841091924",
            "telephone_number": "614-600-4392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "196 Old Military Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Placid",
            "state": "NY",
            "postal_code": "129461940",
            "country_code": "US",
            "telephone_number": "614-600-4392",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 N Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841322400",
            "country_code": "US",
            "telephone_number": "614-600-4392",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Eastwood Mall Blvd",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "OH",
            "postal_code": "444464841",
            "country_code": "US",
            "telephone_number": "614-600-4392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHADE",
        "first_name": "SARAH",
        "middle_name": "MARLENE",
        "credential": "ATC, NREMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "UT",
            "license": "2023038475",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "UT",
            "license": "12945874-4810",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "004879",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT006365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Millcreek, UT
• Providers in Millcreek, UT by specialty
• Athletic Trainer in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.