Stephanie E Black, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT2254 Issued in OH

Practice address

950 W Wooster St
Bowling Green, OH 43402-2603

Phone

(419) 354-8900

NPI assigned

Jan 17, 2007

Sex

Female

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316099666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 BUTTONWOOD AVE",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434023715",
            "telephone_number": "419-807-8344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 W WOOSTER ST",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022603",
            "telephone_number": "419-354-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "STEPHANIE",
        "middle_name": "E",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT2254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bgsu Speech and Hearing Clinic
• Michael John Bielefeld, MD
• Jeffrey Bischoff
• Susan Ann Bischoff, LISW
• John Walton Black
• Jennifer Blasingim
• Evamaria Blass, PHD
• Cathleen Blatchly, PT
• Kelly J Blickensderfer, CFNP
• Kyra L Bloom, LMT

• Athletic Trainer in Bowling Green, OH
• Providers in Bowling Green, OH by specialty
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.