Active NPI
Kaitlyn Jensen, MS, ATC, ATR
- Athletic Trainer
- Eagan, MN
National Provider Identifier
1376999052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2404
- Practice address
- 4185 Braddock TRL
Eagan, MN 55123-1575 - Phone
- (651) 683-6945
- NPI assigned
- May 11, 2016
- Sex
- Female
- 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 | 2404 | MN | Primary |
Addresses
Primary practice location
4185 Braddock TRL
Eagan, MN 55123-1575
Mailing address
4200 Dahlberg Dr
#300
Golden Valley, MN 55422-4840
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462924800000",
"number": "1376999052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4200 DAHLBERG DR",
"address_2": "#300",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554224840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4185 BRADDOCK TRL",
"city": "EAGAN",
"state": "MN",
"postal_code": "551231575",
"telephone_number": "651-683-6945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "KAITLYN",
"credential": "MS, ATC, ATR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-11",
"last_updated": "2016-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "2404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.