Individual provider Active NPI

Jacob Hunter Krauss

  • Athletic Trainer
  • Waxhaw, NC
National Provider Identifier
1164810032
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
8819 Richardson King Rd
Waxhaw, NC 28173-7611
Phone
(704) 290-8644
NPI assigned
Dec 31, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

8819 Richardson King Rd
Waxhaw, NC 28173-7611

Mailing address

8819 Richardson King Rd
Waxhaw, NC 28173-7611
Phone (704) 290-8644

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": "1419984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1164810032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8819 RICHARDSON KING RD",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281737611",
            "telephone_number": "704-290-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8819 RICHARDSON KING RD",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281737611",
            "telephone_number": "704-290-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSS",
        "first_name": "JACOB",
        "middle_name": "HUNTER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-31",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxhaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.

Verify at the official NPI Registry.