Individual provider Active NPI

Stephen Trainor, M.D.

  • Pediatrics Physician
  • Bloomington, IL
National Provider Identifier
1144331828
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036069025 Issued in IL
Practice address
302 Saint Joseph Dr
Bloomington, IL 61701-3506
Phone
(309) 664-3100
Fax
(309) 664-3027
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036069025 IL Primary

Addresses

Primary practice location

302 Saint Joseph Dr
Bloomington, IL 61701-3506

Mailing address

302 Saint Joseph Dr
Bloomington, IL 61701-3506
Phone (309) 664-3100

Other identifiers 1

IdentifierTypeStateIssuer
IL2613OtherILMEDICARE GROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091110000136 IL Practitioner - Pediatric Medicine 4082752225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1144331828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 SAINT JOSEPH DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013506",
            "telephone_number": "309-664-3100",
            "fax_number": "309-664-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 SAINT JOSEPH DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013506",
            "telephone_number": "309-664-3100",
            "fax_number": "309-664-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAINOR",
        "first_name": "STEPHEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036069025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "IL2613",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.