Active NPI
Jacob Austin Schroeder, MS, LAT, ATC, CSCS
- Athletic Trainer
- Indianapolis, IN
National Provider Identifier
1306254339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36002398A
- Practice address
- 1200 N Girls School Rd
Indianapolis, IN 46214-3499 - Phone
- (317) 988-7000
- NPI assigned
- Jul 22, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 36002398A | IN | Primary |
Addresses
Primary practice location
1200 N Girls School Rd
Indianapolis, IN 46214-3499
Mailing address
6748 Dorchester Dr
Zionsville, IN 46077-9162
Phone (812) 345-1913
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Diagnotes |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36002398A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587081600000",
"number": "1306254339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6748 DORCHESTER DR",
"city": "ZIONSVILLE",
"state": "IN",
"postal_code": "460779162",
"telephone_number": "812-345-1913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N GIRLS SCHOOL RD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462143499",
"telephone_number": "317-988-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROEDER",
"first_name": "JACOB",
"middle_name": "AUSTIN",
"credential": "MS, LAT, ATC, CSCS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-22",
"last_updated": "2020-04-17",
"certification_date": "2020-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36002398A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Diagnotes",
"affiliation": "N",
"address_1": "1200 N Girls School Rd",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462143499",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.