Active NPI
Maria Elizabeth Garcia, LAT, ATC
- Athletic Trainer
- Charleston, IL
National Provider Identifier
1831603653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096.005256
- Practice address
- 600 Lincoln Ave
Charleston, IL 61920-3011 - Phone
- (574) 808-8714
- NPI assigned
- Dec 1, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 096.005256 | IL | Primary |
Addresses
Primary practice location
600 Lincoln Ave
Charleston, IL 61920-3011
Mailing address
405 S 2ND St
Monticello, IN 47960-2259
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 |
|---|---|---|---|
| 096.005256 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636416000000",
"number": "1831603653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 S 2ND ST",
"city": "MONTICELLO",
"state": "IN",
"postal_code": "479602259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 LINCOLN AVE",
"city": "CHARLESTON",
"state": "IL",
"postal_code": "619203011",
"telephone_number": "574-808-8714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "MARIA",
"middle_name": "ELIZABETH",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-01",
"last_updated": "2021-11-09",
"certification_date": "2021-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096.005256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.