Individual provider Active NPI

Mary Esther Swanstrom, ATC

  • Athletic Trainer
  • Houston, TX
National Provider Identifier
1861043416
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT8316 Issued in TX
Practice address
8380 El Mundo St Apt 415
Houston, TX 77054-4627
Phone
(773) 499-9449
NPI assigned
Sep 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096.004577 IL
Athletic Trainer 2255A2300X AT8316 TX Primary

Addresses

Primary practice location

8380 El Mundo St Apt 415
Houston, TX 77054-4627

Mailing address

8380 El Mundo St Apt 415
Houston, TX 77054-4627
Phone (773) 499-9449

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

LicenseStateTypeSpecialty
096.004577ILMDAthletic Trainer
AT8316TXMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1861043416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8380 EL MUNDO ST APT 415",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770544627",
            "telephone_number": "773-499-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 EL MUNDO ST APT 415",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770544627",
            "telephone_number": "773-499-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSTROM",
        "first_name": "MARY",
        "middle_name": "ESTHER",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.004577",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT8316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.