Active NPI
Shigeru Takeuchi, ATC
- Athletic Trainer
- Terre Haute, IN
National Provider Identifier
1851401970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36001300A
- Practice address
- Athletic Training Department
Indiana State University
Terre Haute, IN 47809-0001 - Phone
- (812) 237-9613
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- 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 | 36001300A | IN | Primary |
Addresses
Primary practice location
Athletic Training Department
Indiana State University
Terre Haute, IN 47809-0001
Mailing address
201 Crawford St Apt 317
Terre Haute, IN 47807-4660
Phone (812) 237-7423
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 |
|---|---|---|---|
| 36001300A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1851401970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 CRAWFORD ST APT 317",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478074660",
"telephone_number": "812-237-7423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ATHLETIC TRAINING DEPARTMENT",
"address_2": "INDIANA STATE UNIVERSITY",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478090001",
"telephone_number": "812-237-9613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAKEUCHI",
"first_name": "SHIGERU",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36001300A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Terre Haute, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.