Michael A Stroud

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

License

96000511 Issued in IL

Practice address

305 W Jackson St Ste LL02
Carbondale, IL 62901-1474

Phone

(618) 549-0721

NPI assigned

Feb 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720126501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 DOGWOOD LN",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181624",
            "telephone_number": "618-985-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W JACKSON ST STE LL02",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-549-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROUD",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "IL",
            "license": "96000511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sam Stokes III, M.D.
• Dawn Marie Stowers, NP
• Stacy Marie Stratton, DT
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• James Sullivan, MD
• Donald Charles Summerlin, DDS
• Dwayne Gail Summers, DMD
• Lynn A Suppan, CRNA

• All providers in Carbondale, IL
• Rehabilitation Practitioner in Illinois

• 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.