Individual provider Active NPI

Nicholas B Hoover, ATC

  • Athletic Trainer
  • South Bend, IN
National Provider Identifier
1043776321
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
36001557A Issued in IN
Practice address
52695 Sporn Dr
South Bend, IN 46635-1228
Phone
(260) 221-0214
NPI assigned
Feb 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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 36001557A IN Primary

Addresses

Primary practice location

52695 Sporn Dr
South Bend, IN 46635-1228

Mailing address

52695 Sporn Dr
South Bend, IN 46635-1228
Phone (260) 221-0214

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
36001557AINMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1043776321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52695 SPORN DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351228",
            "telephone_number": "260-221-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52695 SPORN DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351228",
            "telephone_number": "260-221-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOVER",
        "first_name": "NICHOLAS",
        "middle_name": "B",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36001557A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.