Active NPI
Benedict William Stollberg, ATC, LAT
- Athletic Trainer
- Metairie, LA
National Provider Identifier
1417358441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT0558
- Practice address
- 5800 Airline Dr
Metairie, LA 70003-3876 - Phone
- (504) 733-0255
- NPI assigned
- Sep 9, 2014
- 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 | AT0558 | MS | Primary |
Addresses
Primary practice location
5800 Airline Dr
Metairie, LA 70003-3876
Mailing address
537 Avenue of Patriots St
Starkville, MS 39759-3103
Phone (262) 689-1236
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 |
|---|---|---|---|
| AT0558 | MS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410220800000",
"number": "1417358441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "537 AVENUE OF PATRIOTS ST",
"city": "STARKVILLE",
"state": "MS",
"postal_code": "397593103",
"telephone_number": "262-689-1236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5800 AIRLINE DR",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700033876",
"telephone_number": "504-733-0255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLLBERG",
"first_name": "BENEDICT",
"middle_name": "WILLIAM",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-09",
"last_updated": "2014-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MS",
"license": "AT0558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Metairie, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.