Individual provider Active NPI

Stacie Lyn Lonquist, ATC

  • Athletic Trainer
  • Redding, CA
National Provider Identifier
1689172405
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
029702647
Practice address
1255 Liberty St
Redding, CA 96001-0814
Phone
(530) 246-2467
Fax
(530) 224-2229
NPI assigned
Jan 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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 029702647 Primary

Addresses

Primary practice location

1255 Liberty St
Redding, CA 96001-0814

Mailing address

1255 Liberty St
Redding, CA 96001-0814
Phone (530) 246-2467

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

NPI Registry JSON

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

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1689172405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 LIBERTY ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010814",
            "telephone_number": "530-246-2467",
            "fax_number": "530-224-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 LIBERTY ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010814",
            "telephone_number": "530-246-2467",
            "fax_number": "530-224-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONQUIST",
        "first_name": "STACIE",
        "middle_name": "LYN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-26",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": "029702647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; 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.