Active NPI
David M Noble, LAT, ATC
- Athletic Trainer
- Chicago, IL
National Provider Identifier
1386619989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 096-002565 | IL | MD | Athletic Trainer |
| 36000521A | IN | MD | Athletic 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.