Jill Struble, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

36002178A Issued in IN

Practice address

600 Legacy PLZ W
La Porte, IN 46350-5268

Phone

(219) 362-8761

NPI assigned

Jul 15, 2014

Last updated

Jul 15, 2014By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1417364050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 S JOHN ST",
            "city": "NORTH JUDSON",
            "state": "IN",
            "postal_code": "463668703",
            "telephone_number": "937-423-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 LEGACY PLZ W",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463505268",
            "telephone_number": "219-362-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRUBLE",
        "first_name": "JILL",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36002178A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF CERTIFICATION",
            "identifier": "060802297",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA ATHLETIC TRAINERS BOARD",
            "identifier": "36002178A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lois Ann Stockwell, COTA
• Sara Stortz, PHARMD
• Jocelyn Leigh Stowell, FNP
• Lyjia O'Layinka Strachan, M.D.
• Sherrie L Stringer
• Monica Studtman
• Eric N Stulc, D.C.
• Kayla Suchanuk, MA, LMHC
• Bradley W Summer, PT
• Summerville 2, LLC (Brentwood at LaPorte)

• Athletic Trainer in La Porte, IN
• Providers in La Porte, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.

Verify at the official NPI Registry.