Active NPI
Stacie Nichole Woodworth, ATC
- Athletic Trainer
- Sycamore, IL
National Provider Identifier
1932257110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 96001400
- Practice address
- 2128 Midlands CT
Sycamore, IL 60178-3199 - Phone
- (815) 758-0000
- NPI assigned
- Jan 6, 2007
- Last updated
- Dec 29, 2015
- 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 | 96001400 | IL | Primary |
Addresses
Primary practice location
2128 Midlands CT
Sycamore, IL 60178-3199
Mailing address
315 W Chester Dr
Maple Park, IL 60151-9193
Phone (630) 707-7556
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 |
|---|---|---|---|
| 96001400 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451347200000",
"number": "1932257110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 W CHESTER DR",
"city": "MAPLE PARK",
"state": "IL",
"postal_code": "601519193",
"telephone_number": "630-707-7556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2128 MIDLANDS CT",
"city": "SYCAMORE",
"state": "IL",
"postal_code": "601783199",
"telephone_number": "815-758-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODWORTH",
"first_name": "STACIE",
"middle_name": "NICHOLE",
"name_prefix": "Mrs.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-06",
"last_updated": "2015-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "96001400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sycamore, IL
- Jacqueline Therese Wirth, DNP, APRN, CPNP-PC
- Stephen C Withrow, PSYD
- WNKS, Inc. (Beltone-Valley Hearing Aid Service)
- Jennifer Wolfe, RN, BSN SCHOOL NURSE
- Stephen L Woodrick, DDS
- Mary J Wrobel, MA/CCC SLP
- Shannon Wuestenberg, APRN
- Omobolanle Gloria Wunuken
- Jacque Wyffels, PHARMD
- Toney Xidis, MSW, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.