Jessica Marie Clanin, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

36002623A Issued in IN

Practice address

14455 Clay Terrace Blvd # Ab
Carmel, IN 46032

Phone

(317) 415-5747

NPI assigned

Mar 11, 2016

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

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": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1265893754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7448 PAWTUCKET CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502755",
            "telephone_number": "815-323-9628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14455 CLAY TERRACE BLVD # AB",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "46032",
            "telephone_number": "317-415-5747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Falcon Way SW",
            "address_purpose": "LOCATION",
            "city": "Poplar Grove",
            "state": "IL",
            "postal_code": "610658803",
            "country_code": "US",
            "telephone_number": "815-323-9628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLANIN",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-11",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36002623A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Carmel, IN
• Providers in Carmel, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.