Bethany Ellen Storck, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1119 Issued in TN

Practice address

117 Stokely Athletic Ctr
Knoxville, TN 37996-0001

Phone

(865) 974-6485

NPI assigned

Dec 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212278400000",
    "number": "1366500472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 WILSON RD",
            "address_2": "APARTMENT 431",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379126033",
            "telephone_number": "203-417-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 STOKELY ATHLETIC CTR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379960001",
            "telephone_number": "865-974-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORCK",
        "first_name": "BETHANY",
        "middle_name": "ELLEN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NH",
            "license": "327",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "1119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOC CERTIFICATION NUMBER",
            "identifier": "060602170",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheyann Melanie Stooksbury
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• James Franklin Stooksbury
• Lindsay Anna Stooksbury, PA
• Sydney Nelson Stooksbury
• Katrina Storms
• Janis Margaret Storry, OTR/L
• Starla Jo Story, B.S.
• Ashley Stoudt
• Jacob Stout, PHARM.D.

• Athletic Trainer in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Athletic Trainer in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2008; 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.