Individual provider Active NPI

Nathan Stahl

  • Student in an Organized Health Care Education/Training Program
  • West Peoria, IL
National Provider Identifier
1366896953
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2516 W Downs Cir
West Peoria, IL 61604-5040
Phone
(309) 258-5509
NPI assigned
Apr 20, 2016
Last updated
Apr 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Specialties & licenses 1

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

Addresses

Primary practice location

2516 W Downs Cir
West Peoria, IL 61604-5040

Mailing address

2516 W Downs Cir
West Peoria, IL 61604-5040

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

NPI Registry JSON

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461110400000",
    "number": "1366896953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 W DOWNS CIR",
            "city": "WEST PEORIA",
            "state": "IL",
            "postal_code": "616045040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 W DOWNS CIR",
            "city": "WEST PEORIA",
            "state": "IL",
            "postal_code": "616045040",
            "telephone_number": "309-258-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHL",
        "first_name": "NATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-20",
        "last_updated": "2016-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; 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.