Active NPI
Drew Stocksdale, CMT
- Mechanotherapist
- Bloomington, IN
National Provider Identifier
1477959302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- MT20902975
- Practice address
- 600 N Jordan Ave
Health Center Health and Wellness
Bloomington, IN 47405-3190 - Phone
- (812) 855-8230
- NPI assigned
- Nov 4, 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 |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MT20902975 | IN | Primary |
Addresses
Primary practice location
600 N Jordan Ave
Health Center Health and Wellness
Bloomington, IN 47405-3190
Mailing address
600 N Jordan Ave
Health Center Health and Wellness
Bloomington, IN 47405-3190
Phone (812) 855-8230
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 |
|---|---|---|---|
| MT20902975 | IN | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415059200000",
"number": "1477959302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 N JORDAN AVE",
"address_2": "HEALTH CENTER HEALTH AND WELLNESS",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474053190",
"telephone_number": "812-855-8230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N JORDAN AVE",
"address_2": "HEALTH CENTER HEALTH AND WELLNESS",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474053190",
"telephone_number": "812-855-8230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOCKSDALE",
"first_name": "DREW",
"credential": "CMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-04",
"last_updated": "2014-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "IN",
"license": "MT20902975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.