Jacklyn Marie Puopolo

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

658 Boulton St
Bel Air, MD 21014-4214

Phone

(410) 638-9400

NPI assigned

Jun 12, 2018

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1285127340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 WILSON BLVD APT 223",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222013374",
            "telephone_number": "502-724-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 BOULTON ST",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144214",
            "telephone_number": "410-638-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUOPOLO",
        "first_name": "JACKLYN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Progressive Physical Therapy, LLC
• Erin Prokop, C.F.N.P.
• Clinton David Protack, MD
• Lisa Proutt, PT
• Lindsey Provelengios, LCPC
• Elizabeth L Purdum, LMSW
• Peter Joseph Purol
• Khalid Puthawala, M.D.
• Noah Putnam
• Quality Connections Counseling Services, LLC

• Student in an Organized Health Care Education/Training Program in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Student in an Organized Health Care Education/Training Program in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.