Active NPI
Megan Blackburn
- Athletic Trainer
- Rockford, IL
National Provider Identifier
1043677099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 5022 Arbutus Rd
Rockford, IL 61107-2402 - Phone
- (815) 243-2213
- NPI assigned
- Jan 21, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary | ||
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
5022 Arbutus Rd
Rockford, IL 61107-2402
Mailing address
5022 Arbutus Rd
Rockford, IL 61107-2402
Phone (815) 243-2213
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453334400000",
"number": "1043677099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5022 ARBUTUS RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611072402",
"telephone_number": "815-243-2213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5022 ARBUTUS RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611072402",
"telephone_number": "815-243-2213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKBURN",
"first_name": "MEGAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-21",
"last_updated": "2016-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.