Active NPI
Taylor Ann Truesdell
- Athletic Trainer
- Meridian, ID
National Provider Identifier
1578055885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-772
- Practice address
- 502 S Eagle Rd
Meridian, ID 83642 - Phone
- (208) 706-5000
- NPI assigned
- Jun 1, 2018
- 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 | AT-772 | ID | Primary |
Addresses
Primary practice location
502 S Eagle Rd
Meridian, ID 83642
Mailing address
1710 Emerald Ave
Caldwell, ID 83605-4794
Phone (208) 230-3878
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000038852 | Other | BOC NUMBER | |
| AT-772 | Other | ID | STATE LICENSURE NUMBER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | truesdet@slhs.org | Direct |
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 |
|---|---|---|---|
| AT-772 | ID | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637020800000",
"number": "1578055885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1710 EMERALD AVE",
"city": "CALDWELL",
"state": "ID",
"postal_code": "836054794",
"telephone_number": "208-230-3878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 S EAGLE RD",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "83642",
"telephone_number": "208-706-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUESDELL",
"first_name": "TAYLOR",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-01",
"last_updated": "2021-11-16",
"certification_date": "2021-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ID",
"license": "AT-772",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOC NUMBER",
"identifier": "2000038852",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSURE NUMBER",
"identifier": "AT-772",
"state": "ID"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "truesdet@slhs.org",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Email",
"address_1": "502 S Eagle Rd",
"city": "Meridian",
"state": "ID",
"country_code": "US",
"postal_code": "83642",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.