Active NPI
Michael Aaron Ybarra, ATC
- Athletic Trainer
- Normal, IL
National Provider Identifier
1396239133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000032650
- Practice address
- 601 Gregory St
Normal, IL 61790-0001 - Phone
- (956) 926-9476
- NPI assigned
- Jun 15, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2000032650 | Primary |
Addresses
Primary practice location
601 Gregory St
Normal, IL 61790-0001
Mailing address
303 Turnberry Dr Apt C
Bloomington, IL 61701-1484
Phone (956) 926-9476
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000032650 | Other | BOARD OF CERTIFICATION |
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": "1529020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529020800000",
"number": "1396239133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 TURNBERRY DR APT C",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617011484",
"telephone_number": "956-926-9476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 GREGORY ST",
"city": "NORMAL",
"state": "IL",
"postal_code": "617900001",
"telephone_number": "956-926-9476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YBARRA",
"first_name": "MICHAEL",
"middle_name": "AARON",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-15",
"last_updated": "2018-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": "2000032650",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF CERTIFICATION",
"identifier": "2000032650",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.