Betty Jean Pollock, ATC, LAT, ITAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

1204 Cloquet Ave
Cloquet, MN 55720

Phone

(218) 878-0805

NPI assigned

Aug 21, 2013

Sex

Female

Sole proprietor

Yes

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": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1114350543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 CLOQUET AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 CLOQUET AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "55720",
            "telephone_number": "218-878-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "BETTY",
        "middle_name": "JEAN",
        "credential": "ATC, LAT, ITAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-21",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Kae Peterson, APRN, CRNA, DNAP
• Carrie Lynn Pfeifer, FNP
• Delorr A. Pickering, LICSW, LCSW
• Jean L Pierce, LP, MA
• Maelyn Pokornowski
• Jessica Powers, PA-C
• Robert Allan Precord
• Proctor Isd 704
• Danielle Prom, DPT
• Joseph Urban Quade, P.T.

• Athletic Trainer in Cloquet, MN
• Providers in Cloquet, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; 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.