Elizabeth Grace Doeller, ATC, EMT-B

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000053256 Issued in NU

Practice address

5650 Bollettieri Blvd
Bradenton, FL 34210-2211

Phone

(800) 872-6425

NPI assigned

Feb 7, 2022

Last updated

Dec 15, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1588318836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3912 41ST ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342052327",
            "telephone_number": "571-232-8463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5650 BOLLETTIERI BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342102211",
            "telephone_number": "800-872-6425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOELLER",
        "first_name": "ELIZABETH",
        "middle_name": "GRACE",
        "credential": "ATC, EMT-B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": "2000053256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED ATHLETIC TRAINER",
            "identifier": "2000053256",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMT",
            "identifier": "B202000367",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.