Active NPI
Jessica Kristie Hafner, ATC/L
- Athletic Trainer
- Saint Johns, MI
National Provider Identifier
1154849438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1203
- Practice address
- 508 Galaxy Way
Saint Johns, MI 48879-2187 - Phone
- (989) 400-6083
- NPI assigned
- Sep 6, 2017
- 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 | 1203 | OK | Primary |
Addresses
Primary practice location
508 Galaxy Way
Saint Johns, MI 48879-2187
Mailing address
508 Galaxy Way
Saint Johns, MI 48879-2187
Phone (989) 400-6083
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625011200000",
"number": "1154849438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 GALAXY WAY",
"city": "SAINT JOHNS",
"state": "MI",
"postal_code": "488792187",
"telephone_number": "989-400-6083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 GALAXY WAY",
"city": "SAINT JOHNS",
"state": "MI",
"postal_code": "488792187",
"telephone_number": "989-400-6083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAFNER",
"first_name": "JESSICA",
"middle_name": "KRISTIE",
"credential": "ATC/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-06",
"last_updated": "2021-06-30",
"certification_date": "2021-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OK",
"license": "1203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Johns, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.