Jacquelyn Ehrenberg, MS, LAT, ATC, CES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RTO000134 Issued in PA

Practice address

472 Sylvania Dr
MC Murray, PA 15317-5333

Phone

(724) 650-5048

NPI assigned

Jun 25, 2016

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

Other identifiers 1

Other names 1

• Ms. Jacquelyn Danhires Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1466812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466812800000",
    "number": "1316398993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 SYLVANIA DR",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153175333",
            "telephone_number": "724-650-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 SYLVANIA DR",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153175333",
            "telephone_number": "724-650-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRENBERG",
        "first_name": "JACQUELYN",
        "name_prefix": "Mrs.",
        "credential": "MS, LAT, ATC, CES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-25",
        "last_updated": "2016-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RTO000134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL ATHLETIC TRAINERS' BOARD OF CERTIFICATION, INC",
            "identifier": "2000006014",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "DANHIRES",
            "prefix": "MS.",
            "credential": "MS, LAT, ATC, CES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Athletic Trainer in MC Murray, PA
• Providers in MC Murray, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2016; 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.