Active NPI
Marisa Anne Colston, PHD, ATC
- Athletic Trainer
- Chattanooga, TN
National Provider Identifier
1578010237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 511
- Practice address
- 615 McCallie Ave
Dept. 6606
Chattanooga, TN 37403-2504 - Phone
- (423) 425-4743
- NPI assigned
- Sep 9, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 511 | TN | Primary |
Addresses
Primary practice location
615 McCallie Ave
Dept. 6606
Chattanooga, TN 37403-2504
Mailing address
615 McCallie Ave
Dept. 6606
Chattanooga, TN 37403-2504
Phone (423) 425-4743
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 511 | TN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473379200000",
"number": "1578010237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 MCCALLIE AVE",
"address_2": "DEPT. 6606",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374032504",
"telephone_number": "423-425-4743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 MCCALLIE AVE",
"address_2": "DEPT. 6606",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374032504",
"telephone_number": "423-425-4743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLSTON",
"first_name": "MARISA",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "PHD, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-09",
"last_updated": "2016-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.