Individual provider Active NPI

Jennifer M Tindall, ATC/L

  • Athletic Trainer
  • West Palm Beach, FL
National Provider Identifier
1356541973
Registry record updated Jul 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL1627 Issued in FL
Practice address
1920 Palm Beach Lakes Blvd
Suite 110
West Palm Beach, FL 33409-3512
Phone
(561) 688-7911
Fax
(561) 688-2498
NPI assigned
Jul 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AL1627 FL Primary

Addresses

Primary practice location

1920 Palm Beach Lakes Blvd
Suite 110
West Palm Beach, FL 33409-3512

Mailing address

1920 Palm Beach Lakes Blvd
Suite 110
West Palm Beach, FL 33409-3512
Phone (561) 688-7911

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

State licenses

LicenseStateTypeSpecialty
AL1627FLMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Institute of Rehabilitation & Sports Training, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185062400000",
    "number": "1356541973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 PALM BEACH LAKES BLVD",
            "address_2": "SUITE 110",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334093512",
            "telephone_number": "561-688-7911",
            "fax_number": "561-688-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 PALM BEACH LAKES BLVD",
            "address_2": "SUITE 110",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334093512",
            "telephone_number": "561-688-7911",
            "fax_number": "561-688-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINDALL",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "ATC/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-22",
        "last_updated": "2007-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL1627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2007; 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.