Active NPI
Collin Gilmore, ATC, LAT
- Athletic Trainer
- Springfield, MO
National Provider Identifier
1740727544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2016032097
- Practice address
- 901 S National Ave
Springfield, MO 65897-0027 - Phone
- (417) 836-5461
- NPI assigned
- Jan 31, 2017
- Sex
- Male
- 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 | 2016032097 | MO | Primary |
Addresses
Primary practice location
901 S National Ave
Springfield, MO 65897-0027
Mailing address
925 South Ave Apt 202F
Springfield, MO 65806-3236
Phone (573) 289-2704
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649341272 | Other | MO | FACILITY NPI NUMBER |
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 |
|---|---|---|---|
| 2016032097 | MO | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485820800000",
"number": "1740727544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 SOUTH AVE APT 202F",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658063236",
"telephone_number": "573-289-2704"
},
{
"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": "GILMORE",
"first_name": "COLLIN",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-31",
"last_updated": "2017-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MO",
"license": "2016032097",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FACILITY NPI NUMBER",
"identifier": "1649341272",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
- Chelsea A Gilliam, PSYD, LP
- Gretta Lynn Gilliam, DNP, ARNP, FNP-C
- Lawrence Lea Cockroft Gilliland, M.D.
- Shanna Michelle Gilliland, DNP, FNP-BC
- Addison Blaire Gilmore
- Katarzyna Gilpatrick, LPC
- Joseph Brent Gilstrap, L.P.C.
- Samantha Rae Gimlin
- Gipson, Arquitt, Meyer and Shaner DDS, PC
- James David Gipson, DDS MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.