Active NPI
Maritza E Chavez Stahly, LAT, ATC
- Athletic Trainer
- Goshen, IN
National Provider Identifier
1124590237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36002466A
- Practice address
- 1824 Dorchester CT Ste a
Goshen, IN 46526-6819 - Phone
- (574) 534-2548
- NPI assigned
- Dec 31, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 36002466A | IN | Primary |
Addresses
Primary practice location
1824 Dorchester CT Ste a
Goshen, IN 46526-6819
Mailing address
318 W Oakridge Ave
Goshen, IN 46528-2652
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 |
|---|---|---|---|
| 36002466A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546214400000",
"number": "1124590237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 W OAKRIDGE AVE",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465282652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1824 DORCHESTER CT STE A",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465266819",
"telephone_number": "574-534-2548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVEZ STAHLY",
"first_name": "MARITZA",
"middle_name": "E",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-31",
"last_updated": "2018-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36002466A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goshen, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.