Active NPI
Elizabeth Ann Slater, MA, ATC, LAT
- Athletic Trainer
- Fort Wayne, IN
National Provider Identifier
1942234356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36001428A
- Practice address
- 7601 W Jefferson Blvd
Fort Wayne, IN 46804-4133 - Phone
- (260) 435-2626
- NPI assigned
- Jul 10, 2006
- 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 | 36001428A | IN | Primary |
Addresses
Primary practice location
7601 W Jefferson Blvd
Fort Wayne, IN 46804-4133
Mailing address
8930 Crosier Lane
Fort Wayne, IN 46825
Phone (260) 402-5204
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36001428A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269302400000",
"number": "1942234356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8930 CROSIER LANE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "46825",
"telephone_number": "260-402-5204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7601 W JEFFERSON BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468044133",
"telephone_number": "260-435-2626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLATER",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MA, ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-10",
"last_updated": "2010-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36001428A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.