Individual provider Active NPI

Linda Tecklenburg, ATC

  • Athletic Trainer
  • Wilmington, OH
National Provider Identifier
1467665372
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT001202 Issued in OH
Practice address
1870 Quaker Way
Wilmington, OH 45177
Phone
(937) 382-6661
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT001202 OH Primary

Addresses

Primary practice location

1870 Quaker Way
Wilmington, OH 45177

Mailing address

5875 Sentinel Ridge LN
Cincinnati, OH 45243-3507
Phone (513) 271-4158

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

LicenseStateTypeSpecialty
AT001202OHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467665372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 SENTINEL RIDGE LN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452433507",
            "telephone_number": "513-271-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 QUAKER WAY",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "45177",
            "telephone_number": "937-382-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TECKLENBURG",
        "first_name": "LINDA",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT001202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.