Active NPI
Jenah Tracy
- Athletic Trainer
- Jacksonville, AL
National Provider Identifier
1003325275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1952
- Practice address
- 700 Pelham Rd N
Jacksonville, AL 36265-1602 - Phone
- (239) 227-9632
- NPI assigned
- Sep 20, 2017
- Last updated
- Sep 20, 2017
- Sex
- Female
- 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 | 1952 | AL | Primary |
Addresses
Primary practice location
700 Pelham Rd N
Jacksonville, AL 36265-1602
Mailing address
213 Dent Dr
Naples, FL 34112-5254
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 |
|---|---|---|---|
| 1952 | AL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505865600000",
"number": "1003325275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 DENT DR",
"city": "NAPLES",
"state": "FL",
"postal_code": "341125254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 PELHAM RD N",
"city": "JACKSONVILLE",
"state": "AL",
"postal_code": "362651602",
"telephone_number": "239-227-9632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRACY",
"first_name": "JENAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-20",
"last_updated": "2017-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AL",
"license": "1952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, AL
- The Health Care Authority of the City of Anniston (RMC Jacksonville Physicians)
- The Health Care Authority of the City of Anniston (RMC Jacksonville)
- John Threadcraft, LPC
- Ryleigh C Tibbitt, FNP
- Timothy B Tabor MD PC
- Turning Point Christian Counseling, LLC
- William Ernest Tyndall, M.D.
- Salisia Shunta Valentine, NP
- Shannon McKala Vaughn
- Kewal K Verma, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.