Active NPI
Tamara Sagadore, ATC
- Athletic Trainer
- Normal, IL
National Provider Identifier
1790153120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096003724
- Practice address
- 180 N Adelaide St
Normal, IL 61761-2404 - Phone
- (309) 438-3340
- NPI assigned
- Sep 2, 2015
- 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 | 096003724 | IL | Primary |
Addresses
Primary practice location
180 N Adelaide St
Normal, IL 61761-2404
Mailing address
19 Traders Cir
Apt 368a
Normal, IL 61761-4149
Phone (309) 532-0103
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2-4778 | Other | CERTIFIED ATHLETIC THERAPIST CAT(C) |
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 |
|---|---|---|---|
| 096003724 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441152000000",
"number": "1790153120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 TRADERS CIR",
"address_2": "APT 368A",
"city": "NORMAL",
"state": "IL",
"postal_code": "617614149",
"telephone_number": "309-532-0103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 N ADELAIDE ST",
"city": "NORMAL",
"state": "IL",
"postal_code": "617612404",
"telephone_number": "309-438-3340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAGADORE",
"first_name": "TAMARA",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-02",
"last_updated": "2015-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096003724",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED ATHLETIC THERAPIST CAT(C)",
"identifier": "2-4778",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.