Active NPI
Spencer Williamson, LAT, ATC
- Athletic Trainer
- Tempe, AZ
National Provider Identifier
1952764128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1425
- Practice address
- 1032 W Vaughn St
Tempe, AZ 85283-5446 - Phone
- (480) 226-2224
- Fax
- (844) 261-5625
- NPI assigned
- Apr 4, 2016
- Sex
- Male
- 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 | 1425 | AZ | Primary |
Addresses
Primary practice location
1032 W Vaughn St
Tempe, AZ 85283-5446
Mailing address
7750 Zionsville Rd Ste 800
Indianapolis, IN 46268-5128
Phone (317) 536-4870
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 |
|---|---|---|---|
| 1425 | AZ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647648000000",
"number": "1952764128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7750 ZIONSVILLE RD STE 800",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462685128",
"telephone_number": "317-536-4870",
"fax_number": "844-261-5625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1032 W VAUGHN ST",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852835446",
"telephone_number": "480-226-2224",
"fax_number": "844-261-5625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "SPENCER",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-04",
"last_updated": "2022-03-19",
"certification_date": "2021-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AZ",
"license": "1425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.