Active NPI
Elizabeth L Labombard, MAED, ATC, LAT
- Athletic Trainer
- Bennington, NE
National Provider Identifier
1770122558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 701
- Practice address
- 16610 Bennington Rd
Bennington, NE 68007-5552 - Phone
- (402) 689-3055
- NPI assigned
- Dec 27, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 701 | NE | Primary |
Addresses
Primary practice location
16610 Bennington Rd
Bennington, NE 68007-5552
Mailing address
111 E Alexander St
Valley, NE 68064-9728
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 |
|---|---|---|---|
| 701 | NE | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1770122558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 E ALEXANDER ST",
"city": "VALLEY",
"state": "NE",
"postal_code": "680649728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16610 BENNINGTON RD",
"city": "BENNINGTON",
"state": "NE",
"postal_code": "680075552",
"telephone_number": "402-689-3055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LABOMBARD",
"first_name": "ELIZABETH",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "MAED, ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-27",
"last_updated": "2021-05-24",
"certification_date": "2021-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NE",
"license": "701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bennington, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.