Individual provider Active NPI

Jonathon Lovercamp, ATC, LAT

  • Athletic Trainer
  • Great Bend, KS
National Provider Identifier
1154780146
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
24-01084 Issued in KS
Practice address
245 NE 30 Rd
Great Bend, KS 67530-9251
Phone
(620) 786-1149
NPI assigned
Feb 18, 2016
Last updated
Feb 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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 24-01084 KS Primary

Addresses

Primary practice location

245 NE 30 Rd
Great Bend, KS 67530-9251

Mailing address

2600 Adams St Apt 8
Great Bend, KS 67530-7167
Phone (417) 682-1737

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
24-01084KSMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1154780146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 ADAMS ST APT 8",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675307167",
            "telephone_number": "417-682-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 NE 30 RD",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675309251",
            "telephone_number": "620-786-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVERCAMP",
        "first_name": "JONATHON",
        "name_prefix": "Mr.",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-18",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "24-01084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Bend, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; 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.