Jennifer Ashley London, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT002100 Issued in GA

Practice address

812 Cross Court Dr
Augusta, GA 30909-2776

Phone

(704) 254-2399

NPI assigned

Jul 4, 2012

Reactivated

Oct 17, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1341360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1255696399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 CROSS COURT DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309092776",
            "telephone_number": "704-254-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 CROSS COURT DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309092776",
            "telephone_number": "704-254-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONDON",
        "first_name": "JENNIFER",
        "middle_name": "ASHLEY",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-04",
        "last_updated": "2018-10-17",
        "deactivation_date": "2016-07-05",
        "reactivation_date": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "1279",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT002100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Lomax
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• Kim Fredric Lombardy, DC
• Mitchell J Lomis
• Donna Lynn Londino, MD
• Jimmy Londono, DDS
• Elijah Long, DPT
• Eugene Mitchell Long III, M.D.
• Hanna Leigh Kosnik Long, MD
• Janice T Long, MS - COUNSELING

• Athletic Trainer in Augusta, GA
• Providers in Augusta, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.