Jacob Edward Anderson, MS, ATC, OTC, SA-C

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

206 Bedford Way
Franklin, TN 37064-5526

Phone

(615) 595-6436

Fax

(615) 261-2067

NPI assigned

Apr 14, 2008

Last updated

Sep 4, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1053585828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 BEDFORD WAY",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370645526",
            "telephone_number": "321-271-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 BEDFORD WAY",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370645526",
            "telephone_number": "615-595-6436",
            "fax_number": "615-261-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JACOB",
        "middle_name": "EDWARD",
        "credential": "MS, ATC, OTC, SA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-14",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Anderson
• Danika Marie Anderson, OTR/L
• Dava L Anderson
• Emily C Anderson, LPC-MHSP
• Hayley Mowery Anderson, PA-C
• Kathryn Marie Anderson, COTA/L
• Kim Anderson, LPC-MHSP
• Madeline Wood Anderson
• Matthew Joseph James Anderson, M.D.
• Megan Anderson

• Athletic Trainer in Franklin, TN
• Providers in Franklin, TN by specialty
• Athletic Trainer in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.