Active NPI
Jenna Lynn Capps, ATC, LAT
- Athletic Trainer
- Terre Haute, IN
National Provider Identifier
1376966242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36001986A
- Practice address
- 567 N 5TH St
Terre Haute, IN 47809-1903 - Phone
- (224) 627-8743
- NPI assigned
- Jan 29, 2014
- Last updated
- Jan 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 36001986A | IN | Primary |
Addresses
Primary practice location
567 N 5TH St
Terre Haute, IN 47809-1903
Mailing address
2223 Lotus Dr
Round Lake Heights, IL 60073-1169
Phone (224) 627-8742
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
| License | State | Type | Specialty |
|---|---|---|---|
| 36001986A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390953600000",
"number": "1376966242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2223 LOTUS DR",
"city": "ROUND LAKE HEIGHTS",
"state": "IL",
"postal_code": "600731169",
"telephone_number": "224-627-8742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "567 N 5TH ST",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478091903",
"telephone_number": "224-627-8743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAPPS",
"first_name": "JENNA",
"middle_name": "LYNN",
"credential": "ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-29",
"last_updated": "2014-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36001986A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Terre Haute, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.