Jessica Staubin, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000036619

Practice address

1939 Bel Air Dr
Arlington, TX 76010-2114

Phone

(805) 558-4240

NPI assigned

Jun 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1285200774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2047",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 BEL AIR DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760102114",
            "telephone_number": "805-558-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUBIN",
        "first_name": "JESSICA",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT7974",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": "2000036619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NREMT",
            "identifier": "E3171002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DEPARTMENT OF STATE HEALTH SERVICES",
            "identifier": "750415",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cassidy Stedfield
• Mary Lois Stedham, LPC

• Athletic Trainer in Arlington, TX
• Providers in Arlington, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.