Individual provider Active NPI

Lonnie Lee Jauken, ATC,PTA

  • Athletic Trainer
  • Holdrege, NE
National Provider Identifier
1083824734
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
170 Issued in NE
Practice address
1215 Tibbals St
Holdrege, NE 68949-1255
Phone
(308) 995-6134
Fax
(308) 995-4127
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 170 NE Primary

Addresses

Primary practice location

1215 Tibbals St
Holdrege, NE 68949-1255

Mailing address

429 McMillan St
Holdrege, NE 68949-2050
Phone (308) 995-5447

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
170NEMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083824734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 MCMILLAN ST",
            "city": "HOLDREGE",
            "state": "NE",
            "postal_code": "689492050",
            "telephone_number": "308-995-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 TIBBALS ST",
            "city": "HOLDREGE",
            "state": "NE",
            "postal_code": "689491255",
            "telephone_number": "308-995-6134",
            "fax_number": "308-995-4127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAUKEN",
        "first_name": "LONNIE",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "ATC,PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NE",
            "license": "170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holdrege, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.