Jacob Glenn Parish, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

3631 S 6TH St
Springfield, IL 62703-4777

Phone

(217) 744-7529

NPI assigned

Jul 3, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1083100994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7809 HUNT RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627128603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3631 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627034777",
            "telephone_number": "217-744-7529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARISH",
        "first_name": "JACOB",
        "middle_name": "GLENN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julio Pardo, M.D.
• John M Pargulski, D.O.
• Ankit Rajeshkumar Parikh, M.D.
• Brad Paris, M.D.
• Erin M Paris, R.D.
• Alyssa L Park, LCPC
• Robert M. Parker, DPM
• Clayton Gerald Parks, M.D.
• Rachel D Parks, NP
• Aubrey Lynn Ferris Parnell

• Athletic Trainer in Springfield, IL
• Providers in Springfield, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.