NPIMap

Organization Active NPI

Student

  • Student in an Organized Health Care Education/Training Program
  • Petersburg, IL
National Provider Identifier
1285992909
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Legal business name
STUDENT
Practice address
16554 N Meadow LN
Petersburg, IL 62675-6786
Phone
(217) 891-7941
NPI assigned
May 1, 2012
Last updated
May 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

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

Authorized official

Name
Nathan Howarth
Title
Physical Therapy
Phone
(217) 891-7941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

16554 N Meadow LN
Petersburg, IL 62675-6786

Mailing address

16554 N Meadow LN
Petersburg, IL 62675-6786

Other names 1

  • Self Other name

National Provider Directory

National Provider Directory
Tax ID family
Agape Behavioral Center72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 3

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335830400000",
    "number": "1285992909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16554 N MEADOW LN",
            "city": "PETERSBURG",
            "state": "IL",
            "postal_code": "626756786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16554 N MEADOW LN",
            "city": "PETERSBURG",
            "state": "IL",
            "postal_code": "626756786",
            "telephone_number": "217-891-7941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUDENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-01",
        "last_updated": "2012-05-01",
        "status": "A",
        "authorized_official_last_name": "HOWARTH",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "PHYSICAL THERAPY",
        "authorized_official_telephone_number": "217-891-7941"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Self",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Petersburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; 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.