Active NPI
Jaclyn Anderson, ATC
- Athletic Trainer
- Salisbury, MD
National Provider Identifier
1154720696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- A0000626
- Practice address
- 1101 Camden Ave
Salisbury, MD 21801-6837 - Phone
- (410) 422-3890
- NPI assigned
- Aug 21, 2014
- Last updated
- Aug 21, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | A0000626 | MD | Primary |
Addresses
Primary practice location
1101 Camden Ave
Salisbury, MD 21801-6837
Mailing address
1008 Arthur CT
Apartment 455
Salisbury, MD 21804-6560
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
| License | State | Type | Specialty |
|---|---|---|---|
| A0000626 | MD | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408579200000",
"number": "1154720696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 ARTHUR CT",
"address_2": "APARTMENT 455",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218046560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 CAMDEN AVE",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218016837",
"telephone_number": "410-422-3890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JACLYN",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-21",
"last_updated": "2014-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MD",
"license": "A0000626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, MD
- Anchorage Nursing and Rehab Center LLC (Anchorage Rehabilitation and Wellness Center)
- Anchorage Nursing, LLC (Anchorage Nursing & Rehabilitation Center)
- Anchorage SNF LLC (Anchorage Healthcare Center)
- Cynthia Alison Anders
- Gail C.S. Anderson, M.D.
- Jeffrey Walter Anderson, D.O.
- Pamela Anderson, IBCLC
- Valerie Williford Anderson, LCSW-C
- Andrea Erley PC
- Jonathan Andrews, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.