Individual provider Active NPI

Christopher Leigh Siegel, ATC, CSCS, EMT

  • Athletic Trainer
  • Alexandria, MN
National Provider Identifier
1962492017
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
1669 Issued in MN
Practice address
111 17TH Ave E Ste 101
Alexandria, MN 56308-3734
Phone
(320) 762-1144
Fax
(320) 762-1935
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1669 MN Primary

Addresses

Primary practice location

111 17TH Ave E Ste 101
Alexandria, MN 56308-3734

Mailing address

111 17TH Ave E Ste 101
Alexandria, MN 56308-3734
Phone (320) 762-1144

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
Emergency Medical Technician

State licenses

LicenseStateTypeSpecialty
1669MNMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1962492017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 17TH AVE E STE 101",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083734",
            "telephone_number": "320-762-1144",
            "fax_number": "320-762-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 17TH AVE E STE 101",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083734",
            "telephone_number": "320-762-1144",
            "fax_number": "320-762-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "CHRISTOPHER",
        "middle_name": "LEIGH",
        "name_prefix": "Mr.",
        "credential": "ATC, CSCS, EMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "1669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.

Verify at the official NPI Registry.