Individual provider Active NPI

Eric Dwight Gillberg, ATC

  • Athletic Trainer
  • Salina, KS
National Provider Identifier
1548580210
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
24-00462 Issued in KS
Practice address
100 E Claflin Ave
Salina, KS 67401-6167
Phone
(785) 827-5541
NPI assigned
Jun 4, 2010
Last updated
Jun 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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 24-00462 KS Primary

Addresses

Primary practice location

100 E Claflin Ave
Salina, KS 67401-6167

Mailing address

814 Vassar Dr
Salina, KS 67401-4623
Phone (785) 643-4262

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
24-00462KSMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275609600000",
    "number": "1548580210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 VASSAR DR",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674014623",
            "telephone_number": "785-643-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E CLAFLIN AVE",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674016167",
            "telephone_number": "785-827-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLBERG",
        "first_name": "ERIC",
        "middle_name": "DWIGHT",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-04",
        "last_updated": "2010-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "24-00462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salina, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; 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.