Active NPI
Susan Louise Williamson
- Athletic Trainer
- Holbrook, NY
National Provider Identifier
1801900592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 5536416
- Practice address
- 20 Peachtree CT
Suite 105
Holbrook, NY 11741-4616 - Phone
- (631) 467-3700
- Fax
- (631) 467-0928
- NPI assigned
- Aug 18, 2006
- 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 | 5536416 | NY | Primary |
Addresses
Primary practice location
20 Peachtree CT
Suite 105
Holbrook, NY 11741-4616
Mailing address
20 Peachtree CT
Suite 105
Holbrook, NY 11741-4616
Phone (631) 467-3700
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 |
|---|---|---|---|
| 5536416 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801900592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 PEACHTREE CT",
"address_2": "SUITE 105",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117414616",
"telephone_number": "631-467-3700",
"fax_number": "631-467-0928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 PEACHTREE CT",
"address_2": "SUITE 105",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117414616",
"telephone_number": "631-467-3700",
"fax_number": "631-467-0928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "SUSAN",
"middle_name": "LOUISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "5536416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holbrook, NY
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.