Active NPI
Rod Scott, ATC, CES, PES
- Athletic Trainer
- Jacksonville, FL
National Provider Identifier
1235553041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 4967721
- Practice address
- 1 Everbank Field Dr
Jacksonville, FL 32202-1928 - Phone
- (904) 633-6561
- Fax
- (904) 633-6070
- NPI assigned
- Feb 13, 2014
- Last updated
- Feb 13, 2014
- Sex
- Male
- 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 | 4967721 | FL | Primary |
Addresses
Primary practice location
1 Everbank Field Dr
Jacksonville, FL 32202-1928
Mailing address
1 Everbank Field Dr
Jacksonville, FL 32202-1928
Phone (904) 633-6561
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TAXONOMY CODE 2255A2 | Other | FL | PROVIDER TYPE 22 |
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 |
|---|---|---|---|
| 4967721 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392249600000",
"number": "1235553041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 EVERBANK FIELD DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322021928",
"telephone_number": "904-633-6561",
"fax_number": "904-633-6070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 EVERBANK FIELD DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322021928",
"telephone_number": "904-633-6561",
"fax_number": "904-633-6070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "ROD",
"credential": "ATC, CES, PES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-02-13",
"last_updated": "2014-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "4967721",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER TYPE 22",
"identifier": "TAXONOMY CODE 2255A2",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.