Active NPI
Scott William Sunderland, MS, ATC
- Athletic Trainer
- Galesburg, IL
National Provider Identifier
1508834623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 2 E South St
K-226
Galesburg, IL 61401-4986 - Phone
- (309) 341-7378
- Fax
- (309) 341-7091
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- 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 | IL | Primary |
Addresses
Primary practice location
2 E South St
K-226
Galesburg, IL 61401-4986
Mailing address
95 Chestnut CT
Dahinda, IL 61428-9732
Phone (309) 879-2892
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096000438 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1508834623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 CHESTNUT CT",
"city": "DAHINDA",
"state": "IL",
"postal_code": "614289732",
"telephone_number": "309-879-2892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 E SOUTH ST",
"address_2": "K-226",
"city": "GALESBURG",
"state": "IL",
"postal_code": "614014986",
"telephone_number": "309-341-7378",
"fax_number": "309-341-7091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUNDERLAND",
"first_name": "SCOTT",
"middle_name": "WILLIAM",
"credential": "MS, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Galesburg, IL
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.