Active NPI
Savannah Borges, MS, LAT, ATC
- Athletic Trainer
- St Bonifacius, MN
National Provider Identifier
1760920672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 3365
- Practice address
- 4075 Tower St Apt 110
St Bonifacius, MN 55375-1178 - Phone
- (920) 979-6661
- NPI assigned
- Feb 11, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL5183 | FL | |
| Athletic Trainer | 2255A2300X | 3365 | MN | Primary |
Addresses
Primary practice location
4075 Tower St Apt 110
St Bonifacius, MN 55375-1178
Mailing address
4075 Tower St Apt 110
St Bonifacius, MN 55375-1178
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL5183 | FL | MD | Athletic Trainer |
| 3365 | MN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613174400000",
"number": "1760920672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4075 TOWER ST APT 110",
"city": "ST BONIFACIUS",
"state": "MN",
"postal_code": "553751178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4075 TOWER ST APT 110",
"city": "ST BONIFACIUS",
"state": "MN",
"postal_code": "553751178",
"telephone_number": "920-979-6661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORGES",
"first_name": "SAVANNAH",
"credential": "MS, LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-11",
"last_updated": "2021-02-13",
"certification_date": "2021-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL5183",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "3365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Bonifacius, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.