Nathan David Schwartzkopf, ATC

Key facts

NPI

1104243385

Entity type

Individual (NPI type 1)

Primary specialty

Athletic Trainer 2255A2300X

License

096002985 (IL)

Practice address

1340 A Street
Charleston, IL 61920

Phone

(217) 556-4236

NPI assigned

Mar 25, 2014

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 25, 2014.

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1104243385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 A STREET",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "61920",
            "telephone_number": "217-556-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 A STREET",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "61920",
            "telephone_number": "217-556-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZKOPF",
        "first_name": "NATHAN",
        "middle_name": "DAVID",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-25",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096002985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Charleston, IL · Athletic Trainer in Illinois