Individual provider Active NPI

Audrey Ann Rambough, ATC,LAT

  • Athletic Trainer
  • Grand Forks, ND
National Provider Identifier
1528280112
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
189-98 Issued in ND
Practice address
University of North Dakota, Division of Sports Medicine
Hyslop Sports Center Room 144, 2751 2ND Ave. N Stop9013
Grand Forks, ND 58202-9013
Phone
(701) 777-3177
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 189-98 ND Primary

Addresses

Primary practice location

University of North Dakota, Division of Sports Medicine
Hyslop Sports Center Room 144, 2751 2ND Ave. N Stop9013
Grand Forks, ND 58202-9013

Mailing address

1112 Westrac Dr.
#102
Fargo, ND 58103
Phone (701) 400-7257

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
189-98NDMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528280112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 WESTRAC DR.",
            "address_2": "#102",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58103",
            "telephone_number": "701-400-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF NORTH DAKOTA, DIVISION OF SPORTS MEDICINE",
            "address_2": "HYSLOP SPORTS CENTER ROOM 144, 2751 2ND AVE. N STOP9013",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582029013",
            "telephone_number": "701-777-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMBOUGH",
        "first_name": "AUDREY",
        "middle_name": "ANN",
        "credential": "ATC,LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ND",
            "license": "189-98",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.