Active NPI
Marianne Goshorn, MSEDUC,LAT,ATC
- Athletic Trainer
- Elwood, IN
National Provider Identifier
1861703191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36000234A
- Practice address
- 1137 N 19TH St
Elwood, IN 46036-1376 - Phone
- (765) 552-9854
- NPI assigned
- Jul 1, 2010
- Last updated
- Jul 1, 2010
- 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 | 36000234A | IN | Primary |
Addresses
Primary practice location
1137 N 19TH St
Elwood, IN 46036-1376
Mailing address
1024 W Brandon Ave
Marion, IN 46952-1533
Phone (765) 668-7867
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 |
|---|---|---|---|
| 36000234A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277942400000",
"number": "1861703191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1024 W BRANDON AVE",
"city": "MARION",
"state": "IN",
"postal_code": "469521533",
"telephone_number": "765-668-7867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1137 N 19TH ST",
"city": "ELWOOD",
"state": "IN",
"postal_code": "460361376",
"telephone_number": "765-552-9854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSHORN",
"first_name": "MARIANNE",
"credential": "MSEDUC,LAT,ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-01",
"last_updated": "2010-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36000234A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elwood, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.