Active NPI
Dana Barents Harrell, ATC, OPA-C
- Athletic Trainer
- Normal, IL
National Provider Identifier
1932505989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096003796
- Practice address
- 1715 Bradford LN
#140
Normal, IL 61761-5283 - Phone
- (309) 275-3802
- NPI assigned
- Nov 18, 2014
- 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 | 096003796 | IL | Primary |
Addresses
Primary practice location
1715 Bradford LN
#140
Normal, IL 61761-5283
Mailing address
1715 Bradford LN
#140
Normal, IL 61761-5283
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1018849 | Other | NATA CERTIFICATION NUMBER | |
| 110754 | Other | BOARD OF CERTIFICATION ATC |
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 |
|---|---|---|---|
| 096003796 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416268800000",
"number": "1932505989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1715 BRADFORD LN",
"address_2": "#140",
"city": "NORMAL",
"state": "IL",
"postal_code": "617615283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1715 BRADFORD LN",
"address_2": "#140",
"city": "NORMAL",
"state": "IL",
"postal_code": "617615283",
"telephone_number": "309-275-3802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "DANA",
"middle_name": "BARENTS",
"name_prefix": "Miss",
"credential": "ATC, OPA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-18",
"last_updated": "2014-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096003796",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATA CERTIFICATION NUMBER",
"identifier": "1018849",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF CERTIFICATION ATC",
"identifier": "110754",
"state": null
}
],
"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 Nov 18, 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.