Jessica Dawn Achatz, ATC, LAT
Individual provider Active NPI Athletic Trainer · Cary, NC
NPI 1255692091 · NPPES record last updated Jun 7, 2012
Key facts
- NPI
- 1255692091
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 1761 (NC)
- Practice address
- 113 Ribbon LN Apt M
Cary, NC 27518-6887 - Phone
- (719) 469-9608
- NPI assigned
- Jun 7, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1761 | NC | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1761 | NC | Yes |
Addresses
Primary practice location
113 Ribbon LN Apt M
Cary, NC 27518-6887
Mailing address
113 Ribbon LN Apt M
Cary, NC 27518-6887
Phone (719) 469-9608
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000003551 | Other | NC | BOC |
| 1761 | Other | NC | NCBATE |
Other providers in Cary, NC
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All providers in Cary, NC · Athletic Trainer in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.