Active NPI
Jill Elizabeth Stobber, LAT, A.T.,C.
- Athletic Trainer
- Waterford, WI
National Provider Identifier
1801812235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 320-039
- Practice address
- 100 Field Dr
Waterford, WI 53185-4116 - Phone
- (262) 534-3189
- Fax
- (262) 534-4971
- NPI assigned
- Jul 15, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 320-039 | WI | Primary |
Addresses
Primary practice location
100 Field Dr
Waterford, WI 53185-4116
Mailing address
981 Cedar Dr
Burlington, WI 53105-1368
Phone (262) 763-6816
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 |
|---|---|---|---|
| 320-039 | WI | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waterford Union High School | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Local Education Agency (LEA)
- Waterford, WI
- NPI 1326213620
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801812235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "981 CEDAR DR",
"city": "BURLINGTON",
"state": "WI",
"postal_code": "531051368",
"telephone_number": "262-763-6816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 FIELD DR",
"city": "WATERFORD",
"state": "WI",
"postal_code": "531854116",
"telephone_number": "262-534-3189",
"fax_number": "262-534-4971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOBBER",
"first_name": "JILL",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "LAT, A.T.,C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "320-039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterford, WI
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.