Individual provider Active NPI

David M Noble, LAT, ATC

  • Athletic Trainer
  • Chicago, IL
National Provider Identifier
1386619989
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
9645 S Western Ave
Chicago, IL 60643-1722
Phone
(773) 239-2734
Fax
(773) 239-2784
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 36000521A IN
Athletic Trainer 2255A2300X IL Primary

Addresses

Primary practice location

9645 S Western Ave
Chicago, IL 60643-1722

Mailing address

7607 Bancaster Dr
Indianapolis, IN 46268-5717
Phone (317) 876-3216

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

LicenseStateTypeSpecialty
096-002565ILMDAthletic Trainer
36000521AINMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1386619989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7607 BANCASTER DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462685717",
            "telephone_number": "317-876-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9645 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431722",
            "telephone_number": "773-239-2734",
            "fax_number": "773-239-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36000521A",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.