Active NPI
John Richard Storsved II, H.S.D. ATC
- Athletic Trainer
- Decatur, IL
National Provider Identifier
1356313225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096-000920
- Practice address
- 1184 W Main St
Decatur, IL 62522-2084 - Phone
- (217) 424-6364
- NPI assigned
- Feb 6, 2006
- 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 | 096-000920 | IL | Primary |
Addresses
Primary practice location
1184 W Main St
Decatur, IL 62522-2084
Mailing address
2608 S Nottingham CT
Champaign, IL 61821-7015
Phone (176) 218-7972
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
| License | State | Type | Specialty |
|---|---|---|---|
| 096-000920 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561075200000",
"number": "1356313225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2608 S NOTTINGHAM CT",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618217015",
"telephone_number": "176-218-7972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1184 W MAIN ST",
"city": "DECATUR",
"state": "IL",
"postal_code": "625222084",
"telephone_number": "217-424-6364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STORSVED",
"first_name": "JOHN",
"middle_name": "RICHARD",
"name_suffix": "II",
"credential": "H.S.D. ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-06",
"last_updated": "2019-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096-000920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.