Jacklyn Sue Bascomb-Harrison, MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

400 Bizzell St
College Station, TX 77843-0002

Phone

(979) 458-0257

NPI assigned

Nov 9, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacklyn Sue Bascomb Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1164935367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984 RICE DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778031867",
            "telephone_number": "970-301-7183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BIZZELL ST",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778430002",
            "telephone_number": "979-458-0257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASCOMB-HARRISON",
        "first_name": "JACKLYN",
        "middle_name": "SUE",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-09",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKLYN",
            "last_name": "BASCOMB",
            "middle_name": "SUE",
            "credential": "MS, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brian James Barras, D.D.S.
• Amanda Barron, PT, DPT
• Sarah Anne Barron, FNP-C
• Breanna Laice Barry, FNP-C
• Deborah Ann Barton, PHD
• Lori Ann Bastardo, LVN
• Alejandra Basurto
• Ojong-Tabong Bate, PHARMD
• Christopher Charles Bathurst, MD
• Kasey Charlene Batrez, RN

• Athletic Trainer in College Station, TX
• Providers in College Station, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.