Active NPI
Susan Marie Anzalone, ATC
- Athletic Trainer
- Springfield, MO
National Provider Identifier
1710286117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2011005758
- Practice address
- 901 S National Ave
Springfield, MO 65897-0027 - Phone
- (417) 836-5461
- NPI assigned
- Mar 24, 2011
- Last updated
- Mar 24, 2011
- Sex
- Female
- Sole proprietor
- No
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 | 2011005758 | MO | Primary |
Addresses
Primary practice location
901 S National Ave
Springfield, MO 65897-0027
Mailing address
2601 N Cresthaven Ave
H206
Springfield, MO 65803-7826
Phone (314) 494-1304
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 |
|---|---|---|---|
| 2011005758 | MO | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300924800000",
"number": "1710286117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2601 N CRESTHAVEN AVE",
"address_2": "H206",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658037826",
"telephone_number": "314-494-1304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 S NATIONAL AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658970027",
"telephone_number": "417-836-5461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANZALONE",
"first_name": "SUSAN",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-24",
"last_updated": "2011-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MO",
"license": "2011005758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.