Active NPI
Jennifer Pridmore, ATC, LAT
- Athletic Trainer
- Springdale, AR
National Provider Identifier
1154833762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 662
- Practice address
- 101 S Pleasant St
Springdale, AR 72764-4246 - Phone
- (303) 594-3308
- NPI assigned
- Nov 4, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 662 | AR | Primary |
Addresses
Primary practice location
101 S Pleasant St
Springdale, AR 72764-4246
Mailing address
405 E Necessary Rd
Rogers, AR 72758-1311
Phone (303) 594-3308
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 |
|---|---|---|---|
| 662 | AR | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509753600000",
"number": "1154833762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 E NECESSARY RD",
"city": "ROGERS",
"state": "AR",
"postal_code": "727581311",
"telephone_number": "303-594-3308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S PLEASANT ST",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727644246",
"telephone_number": "303-594-3308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIDMORE",
"first_name": "JENNIFER",
"credential": "ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-04",
"last_updated": "2017-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AR",
"license": "662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.