Joseph B Kingdon, ATC/L

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096.003496 Issued in IL

Practice address

1505 Eastland Dr Ste 220
Bloomington, IL 61701-7906

Phone

(309) 662-2278

NPI assigned

Mar 19, 2019

Last updated

Mar 19, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1225597180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 SEARLE DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612866",
            "telephone_number": "630-742-8851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND DR STE 220",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017906",
            "telephone_number": "309-662-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGDON",
        "first_name": "JOSEPH",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "ATC/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.003496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle F Kim, D.O.
• John Junil Kim, DPM
• Alexandra Kindred, PA-C
• Stephen L Kindred, M.D.
• Brittany King, APN
• Amber Kingery
• Shaun Kink, M.D.
• Kirk W. Noraian, D.D.S., M.S., P.C.
• Nicole Anne Kirstein, LCSW
• Suzanne Kishel, LCPC

• Athletic Trainer in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.