Individual provider Active NPI

Elissa Suzanne Hooper, ATC

  • Athletic Trainer
  • Indianapolis, IN
National Provider Identifier
1467549956
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096.001946 Issued in IL
Practice address
5949 W Raymond St
Indianapolis, IN 46241-4348
Phone
(317) 390-5590
Fax
(317) 486-2194
NPI assigned
Oct 6, 2006
Last updated
Dec 11, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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 096.001946 IL Primary
Athletic Trainer 2255A2300X 360010277A IN

Addresses

Primary practice location

5949 W Raymond St
Indianapolis, IN 46241-4348

Mailing address

718 Green Ridge Pkwy
Apt B
Brownsburg, IN 46112-2446
Phone (217) 495-1577

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
096.001946ILMDAthletic Trainer
360010277AINMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1467549956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 GREEN RIDGE PKWY",
            "address_2": "APT B",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461122446",
            "telephone_number": "217-495-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5949 W RAYMOND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462414348",
            "telephone_number": "317-390-5590",
            "fax_number": "317-486-2194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOPER",
        "first_name": "ELISSA",
        "middle_name": "SUZANNE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.001946",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "360010277A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.