Active NPI
Audrey Marquez, AT, LAT
- Athletic Trainer
- Phoenix, AZ
National Provider Identifier
1780113662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1288
- Practice address
- 14400 N Tatum Blvd
Phoenix, AZ 85032-5531 - Phone
- (602) 332-2130
- NPI assigned
- Jun 5, 2017
- 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 | 1288 | AZ | Primary |
Addresses
Primary practice location
14400 N Tatum Blvd
Phoenix, AZ 85032-5531
Mailing address
12057 W Rowel Rd
Peoria, AZ 85383-5866
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 |
|---|---|---|---|
| 1288 | AZ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496620800000",
"number": "1780113662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12057 W ROWEL RD",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853835866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14400 N TATUM BLVD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850325531",
"telephone_number": "602-332-2130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARQUEZ",
"first_name": "AUDREY",
"credential": "AT, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-05",
"last_updated": "2017-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AZ",
"license": "1288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.