Active NPI
Sabrina Colleen Dierksen, ATC, LAT
- Athletic Trainer
- Enid, OK
National Provider Identifier
1942456702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 522
- Practice address
- 201 S Raleigh Rd
Occupational Health Dept.
Enid, OK 73701-7800 - Phone
- (580) 616-4793
- Fax
- (580) 616-1071
- NPI assigned
- Aug 13, 2008
- Last updated
- Jun 26, 2015
- 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 | 522 | OK | Primary |
Addresses
Primary practice location
201 S Raleigh Rd
Occupational Health Dept.
Enid, OK 73701-7800
Mailing address
201 S Raleigh Rd
Occupational Health Dept.
Enid, OK 73701-7800
Phone (580) 616-4793
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04115786643 | Other | OK | AHA BLS INSTUCTOR |
| 522 | Other | OK | STATE LICENSE NUMBER |
| 090402325 | Other | NATIONAL CERTIFICATION |
Other names 1
- Miss Sabrina Colleen Walton
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 |
|---|---|---|---|
| 522 | OK | MD | Renal Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435276800000",
"number": "1942456702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 S RALEIGH RD",
"address_2": "OCCUPATIONAL HEALTH DEPT.",
"city": "ENID",
"state": "OK",
"postal_code": "737017800",
"telephone_number": "580-616-4793",
"fax_number": "580-616-1071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 S RALEIGH RD",
"address_2": "OCCUPATIONAL HEALTH DEPT.",
"city": "ENID",
"state": "OK",
"postal_code": "737017800",
"telephone_number": "580-616-4793",
"fax_number": "580-616-1071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIERKSEN",
"first_name": "SABRINA",
"middle_name": "COLLEEN",
"name_prefix": "Mrs.",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-13",
"last_updated": "2015-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OK",
"license": "522",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHA BLS INSTUCTOR",
"identifier": "04115786643",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "522",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL CERTIFICATION",
"identifier": "090402325",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SABRINA",
"last_name": "WALTON",
"middle_name": "COLLEEN",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Enid, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.