Individual provider Active NPI

Andrew Benning, MS, LAT, ATC

  • Athletic Trainer
  • Normal, IL
National Provider Identifier
1821493461
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096.003879 Issued in IL
Practice address
110 Horton Field House
Campus Box 7130
Normal, IL 61790-7130
Phone
(217) 725-7525
NPI assigned
Oct 24, 2014
Last updated
Oct 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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 096.003879 IL Primary

Addresses

Primary practice location

110 Horton Field House
Campus Box 7130
Normal, IL 61790-7130

Mailing address

110 Hoton Field House
Campus Box 7130
Normal, IL 61790-7130
Phone (217) 725-7525

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
096.003879ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1821493461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HOTON FIELD HOUSE",
            "address_2": "CAMPUS BOX 7130",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617907130",
            "telephone_number": "217-725-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HORTON FIELD HOUSE",
            "address_2": "CAMPUS BOX 7130",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617907130",
            "telephone_number": "217-725-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNING",
        "first_name": "ANDREW",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.003879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.

Verify at the official NPI Registry.