Active NPI
James David Schaefer, MS,ATC
- Athletic Trainer
- Bloomington, IL
National Provider Identifier
1194228387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096002933
- Practice address
- 302 E Emerson St
Bloomington, IL 61701-1768 - Phone
- (309) 556-3340
- NPI assigned
- Mar 14, 2018
- Sex
- Male
- 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 | 096002933 | IL | Primary |
Addresses
Primary practice location
302 E Emerson St
Bloomington, IL 61701-1768
Mailing address
2212 13TH Street
Peru, IL 61354
Phone (815) 252-1237
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096002933 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520985600000",
"number": "1194228387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2212 13TH STREET",
"city": "PERU",
"state": "IL",
"postal_code": "61354",
"telephone_number": "815-252-1237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 E EMERSON ST",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617011768",
"telephone_number": "309-556-3340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHAEFER",
"first_name": "JAMES",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "MS,ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-14",
"last_updated": "2018-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096002933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.