Individual provider Active NPI

Heather Poeschel

  • Athletic Trainer
  • Cortland, IL
National Provider Identifier
1033523840
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096002211 Issued in IL
Practice address
199 E Warbler Ave
Cortland, IL 60112-4084
Phone
(630) 200-5880
NPI assigned
Jun 19, 2014
Last updated
Jun 19, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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 096002211 IL Primary

Addresses

Primary practice location

199 E Warbler Ave
Cortland, IL 60112-4084

Mailing address

199 E Warbler Ave
Cortland, IL 60112-4084

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

LicenseStateTypeSpecialty
096002211ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1033523840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 E WARBLER AVE",
            "city": "CORTLAND",
            "state": "IL",
            "postal_code": "601124084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 E WARBLER AVE",
            "city": "CORTLAND",
            "state": "IL",
            "postal_code": "601124084",
            "telephone_number": "630-200-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POESCHEL",
        "first_name": "HEATHER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096002211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.