Individual provider Active NPI

Nicole K Armstrong, ATC

  • Athletic Trainer
  • Jacksonville, FL
National Provider Identifier
1053676072
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL3104 Issued in FL
Practice address
1325 San Marco Blvd
Suite 102
Jacksonville, FL 32207-8568
Phone
(904) 858-7045
Fax
(904) 858-7047
NPI assigned
Jul 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AL3104 FL Primary

Addresses

Primary practice location

1325 San Marco Blvd
Suite 102
Jacksonville, FL 32207-8568

Mailing address

1325 San Marco Blvd
Suite 102
Jacksonville, FL 32207-8568
Phone (904) 858-7045

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

LicenseStateTypeSpecialty
AL3104FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1053676072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD",
            "address_2": "SUITE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078568",
            "telephone_number": "904-858-7045",
            "fax_number": "904-858-7047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD",
            "address_2": "SUITE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078568",
            "telephone_number": "904-858-7045",
            "fax_number": "904-858-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMSTRONG",
        "first_name": "NICOLE",
        "middle_name": "K",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL3104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; 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.