Individual provider Active NPI

Robert Lynall, ATC

  • Athletic Trainer
  • Normal, IL
National Provider Identifier
1154699486
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096002940 Issued in IL
Practice address
Kaufman Football Building
Campus Box 7160
Normal, IL 61790-0001
Phone
(309) 438-3111
NPI assigned
Dec 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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 096002940 IL Primary

Addresses

Primary practice location

Kaufman Football Building
Campus Box 7160
Normal, IL 61790-0001

Mailing address

Kaufman Football Building
Campus Box 7160
Normal, IL 61790-0001

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
096002940ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1154699486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KAUFMAN FOOTBALL BUILDING",
            "address_2": "CAMPUS BOX 7160",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617900001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KAUFMAN FOOTBALL BUILDING",
            "address_2": "CAMPUS BOX 7160",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617900001",
            "telephone_number": "309-438-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNALL",
        "first_name": "ROBERT",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096002940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.