Active NPI
Jessica Nicole Brogan, LAT, ATC
- Athletic Trainer
- Washington, PA
National Provider Identifier
1003274226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT006253
- Practice address
- 60 S Lincoln St
Washington, PA 15301-4812 - Phone
- (513) 703-7883
- NPI assigned
- Feb 2, 2016
- 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 | RT006253 | PA | Primary |
Addresses
Primary practice location
60 S Lincoln St
Washington, PA 15301-4812
Mailing address
523 Maple Creek Rd
Moscow, OH 45153-9718
Phone (513) 703-7883
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 |
|---|---|---|---|
| RT006253 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454371200000",
"number": "1003274226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 MAPLE CREEK RD",
"city": "MOSCOW",
"state": "OH",
"postal_code": "451539718",
"telephone_number": "513-703-7883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 S LINCOLN ST",
"city": "WASHINGTON",
"state": "PA",
"postal_code": "153014812",
"telephone_number": "513-703-7883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROGAN",
"first_name": "JESSICA",
"middle_name": "NICOLE",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-02",
"last_updated": "2016-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT006253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.