Jennifer Sobotta, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

520-039 Issued in WI

Practice address

1402 Main St
Bloomer, WI 54724-1637

Phone

(715) 568-4669

NPI assigned

May 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1386697696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 PRIDDY ST",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547241146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 MAIN ST",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547241637",
            "telephone_number": "715-568-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBOTTA",
        "first_name": "JENNIFER",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "520-039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Meghan Lea Shadick, M.S., CRC, LPC-IT
• Michael E Shipman, PA-C
• Phillip J Skaar, MD
• Abrahm Skaw, DC
• Emily Sleik
• Barbara Southworth, RDH
• Natia Marie Stadler
• Cassidy Stanger
• Nancy L Stiehm
• Michele Stokka

• Athletic Trainer in Bloomer, WI
• Providers in Bloomer, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.