Jacqueline Anne Lupton, LAT, ATC

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

License

AT004124 Issued in GA

Practice address

824 Stillwood Dr
Savannah, GA 31419-2643

Phone

(912) 961-8764

NPI assigned

Jun 8, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Jacqueline Anne Lloyd Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691884800000",
    "number": "1053840413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 STILLWOOD DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314192643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 STILLWOOD DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314192643",
            "telephone_number": "912-961-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPTON",
        "first_name": "JACQUELINE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2023-08-13",
        "certification_date": "2023-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CO",
            "license": "2000028113",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "GA",
            "license": "AT004124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "LLOYD",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "credential": "LAT, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Lukevich
• Luminous Psychiatry and Therapeutic Services LLC
• Kristy Luna
• Viridian Luna, M.S., CCC-SLP
• Kaye Green Lunsford, LMHC, LPC
• Barry D. Luskey, M.D.
• Nina Luskey, MD
• Carolyn Luten
• Brandis Alexis Luttrell-Mitchell, LCSW
• Eric Lutzenberger, RD, LD

• Sports Medicine (Emergency Medicine) Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Sports Medicine (Emergency Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2023; 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.