Active NPI
Marion Sides Vruggink
- Athletic Trainer
- West Lafayette, IN
National Provider Identifier
1477519346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36000026A
- Practice address
- 1105 N Grant Street
West Lafayette Jr Sr High School
West Lafayette, IN 47906 - Phone
- (765) 746-0424
- Fax
- (765) 746-0426
- NPI assigned
- Apr 21, 2006
- 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 | 36000026A | IN | Primary |
Addresses
Primary practice location
1105 N Grant Street
West Lafayette Jr Sr High School
West Lafayette, IN 47906
Mailing address
320 Dehart Street
West Lafayette, IN 47906
Phone (765) 746-5706
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
| License | State | Type | Specialty |
|---|---|---|---|
| 36000026A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1477519346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 DEHART STREET",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "47906",
"telephone_number": "765-746-5706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 N GRANT STREET",
"address_2": "WEST LAFAYETTE JR SR HIGH SCHOOL",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "47906",
"telephone_number": "765-746-0424",
"fax_number": "765-746-0426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VRUGGINK",
"first_name": "MARION",
"middle_name": "SIDES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-21",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36000026A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.