Southern Illinois Sports Medicine – Athletic Trainer, NPI 1699061259

Southern Illinois Sports Medicine is a healthcare provider. based in Belleville, Illinois. specializing in Athletic Trainer. The organization holds a License No. 096002594 (IL). The NPI Number for Southern Illinois Sports Medicine is 1699061259

Main info

Organization
Name
Southern Illinois Sports Medicine
NPI
1699061259
Phone
(618) 236-2246
Address
4550 MEMORIAL DR
Authorized Official
JASON DANIEL NOELDNER ATHLETIC TRAINER ATC,LAT
Enumeration Date
22 June 2011
Last Update Date
22 June 2011
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness80
Years active:14State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for Southern Illinois Sports Medicine

  • 4550 MEMORIAL DR

    MOC-1, SUITE G-100

    BELLEVILLE, IL 622265372

    Phone: (618) 236-2246

    Fax: (618) 236-2315

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62226)

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Reviews

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Frequently asked questions

Can I verify Southern Illinois Sports Medicine with an NPI only?
You can start verification with NPI 1699061259 for Southern Illinois Sports Medicine, then check state licensing separately.
Does CMS list Southern Illinois Sports Medicine as active?
Yes — Southern Illinois Sports Medicine is active in the NPI listing used on this page.
What taxonomy line describes Southern Illinois Sports Medicine?
For research purposes, treat Southern Illinois Sports Medicine as Athletic Trainer in this dataset. Clinical services aligned with this taxonomy classification.
What area does Southern Illinois Sports Medicine serve?
Southern Illinois Sports Medicine's listing highlights Belleville, Illinois; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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