Active NPI
Elise Fitzsimmons
- Athletic Trainer
- Oswego, NY
National Provider Identifier
1992303572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 100602016
- Practice address
- 9 Laker Hall
Oswego, NY 13126 - Phone
- (315) 312-2941
- NPI assigned
- Oct 15, 2020
- 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 | 100602016 | NY | Primary |
Addresses
Primary practice location
9 Laker Hall
Oswego, NY 13126
Mailing address
9 Laker Hall
Oswego, NY 13126
Phone (315) 312-2941
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 |
|---|---|---|---|
| 100602016 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602720000000",
"number": "1992303572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 LAKER HALL",
"city": "OSWEGO",
"state": "NY",
"postal_code": "13126",
"telephone_number": "315-312-2941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 LAKER HALL",
"city": "OSWEGO",
"state": "NY",
"postal_code": "13126",
"telephone_number": "315-312-2941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZSIMMONS",
"first_name": "ELISE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-15",
"last_updated": "2020-10-15",
"certification_date": "2020-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "100602016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oswego, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.