Individual provider Active NPI

James Eischeid, LAT

  • Athletic Trainer
  • Beloit, WI
National Provider Identifier
1497806665
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
621039 Issued in WI
Practice address
2810 Kennedy Dr
Beloit, WI 53511-3973
Phone
(608) 361-5872
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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 621039 WI Primary

Addresses

Primary practice location

2810 Kennedy Dr
Beloit, WI 53511-3973

Mailing address

557 N Washington St
Janesville, WI 53548-2907
Phone (608) 754-6000

Other identifiers 1

IdentifierTypeStateIssuer
621-039OtherWISTATE LICENSURE

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
621039WIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1497806665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 N WASHINGTON ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482907",
            "telephone_number": "608-754-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 KENNEDY DR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113973",
            "telephone_number": "608-361-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISCHEID",
        "first_name": "JAMES",
        "credential": "LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "621039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE",
            "identifier": "621-039",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.