Individual provider Active NPI

Renee L Woebkenberg, ATC

  • Athletic Trainer
  • Evansville, IN
National Provider Identifier
1215166764
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
36001560A Issued in IN
Practice address
7300 E Indiana St
Suite 102
Evansville, IN 47715-2794
Phone
(812) 476-0409
Fax
(812) 476-1016
NPI assigned
Jul 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

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 36001560A IN Primary

Addresses

Primary practice location

7300 E Indiana St
Suite 102
Evansville, IN 47715-2794

Mailing address

7300 E Indiana St
Suite 102
Evansville, IN 47715-2794
Phone (812) 476-0409

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
36001560AINMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246838400000",
    "number": "1215166764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 E INDIANA ST",
            "address_2": "SUITE 102",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152794",
            "telephone_number": "812-476-0409",
            "fax_number": "812-476-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 E INDIANA ST",
            "address_2": "SUITE 102",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152794",
            "telephone_number": "812-476-0409",
            "fax_number": "812-476-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOEBKENBERG",
        "first_name": "RENEE",
        "middle_name": "L",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2009-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36001560A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; 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.