Active NPI
Jody Powell, ATC, LAT, CCMA, CES
- Athletic Trainer
- Monroe, LA
National Provider Identifier
1013514710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- ATH.200402
- Practice address
- 1600 Arizona Ave
Monroe, LA 71202-3602 - Phone
- (318) 387-2932
- NPI assigned
- Oct 6, 2020
- 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 | ATH.200402 | LA | Primary |
Addresses
Primary practice location
1600 Arizona Ave
Monroe, LA 71202-3602
Mailing address
139 Victory LN
West Monroe, LA 71291-1739
Phone (318) 372-2612
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 |
|---|---|---|---|
| ATH.200402 | LA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601942400000",
"number": "1013514710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 VICTORY LN",
"city": "WEST MONROE",
"state": "LA",
"postal_code": "712911739",
"telephone_number": "318-372-2612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 ARIZONA AVE",
"city": "MONROE",
"state": "LA",
"postal_code": "712023602",
"telephone_number": "318-387-2932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "JODY",
"credential": "ATC, LAT, CCMA, CES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-06",
"last_updated": "2020-10-06",
"certification_date": "2020-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "LA",
"license": "ATH.200402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.