Active NPI
Lorie Ann Allison, ATC, ATL
- Athletic Trainer
- Boise, ID
National Provider Identifier
1790802643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 069
- Practice address
- 600 Robbins Rd
Boise, ID 83702-4539 - Phone
- (208) 489-4040
- NPI assigned
- Mar 24, 2007
- Last updated
- Jul 8, 2007
- 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 | 069 | ID | Primary |
Addresses
Primary practice location
600 Robbins Rd
Boise, ID 83702-4539
Mailing address
4803 W Mystic Cove Dr
Garden City, ID 83714-4785
Phone (208) 404-0730
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 |
|---|---|---|---|
| 069 | ID | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790802643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4803 W MYSTIC COVE DR",
"city": "GARDEN CITY",
"state": "ID",
"postal_code": "837144785",
"telephone_number": "208-404-0730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 ROBBINS RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837024539",
"telephone_number": "208-489-4040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLISON",
"first_name": "LORIE",
"middle_name": "ANN",
"credential": "ATC, ATL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ID",
"license": "069",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.