Active NPI
Brianna Nelson, ATC
- Athletic Trainer
- Saint Louis, MO
National Provider Identifier
1811306459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2014024990
- Practice address
- 1 College Park Dr
Saint Louis, MO 63141-8660 - Phone
- (314) 485-8415
- NPI assigned
- Aug 7, 2014
- 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 | 2014024990 | MO | Primary |
Addresses
Primary practice location
1 College Park Dr
Saint Louis, MO 63141-8660
Mailing address
122 Steamboat LN
#302
Ballwin, MO 63011-3202
Phone (845) 750-1933
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 |
|---|---|---|---|
| 2014024990 | MO | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407369600000",
"number": "1811306459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 STEAMBOAT LN",
"address_2": "#302",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630113202",
"telephone_number": "845-750-1933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 COLLEGE PARK DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418660",
"telephone_number": "314-485-8415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "BRIANNA",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-07",
"last_updated": "2014-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MO",
"license": "2014024990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.