Active NPI
Jonathan Allen, MA, ATC, LAT
- Athletic Trainer
- Connersville, IN
National Provider Identifier
1396071452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36001185A
- Practice address
- 1941 Virginia Ave
Connersville, IN 47331-2833 - Phone
- (765) 827-8052
- NPI assigned
- Oct 26, 2009
- Last updated
- Oct 26, 2009
- Sex
- Male
- 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 | 36001185A | IN | Primary |
Addresses
Primary practice location
1941 Virginia Ave
Connersville, IN 47331-2833
Mailing address
PO Box 468
Dublin, IN 47335-0468
Phone (765) 730-1094
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36001185A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256515200000",
"number": "1396071452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 468",
"city": "DUBLIN",
"state": "IN",
"postal_code": "473350468",
"telephone_number": "765-730-1094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1941 VIRGINIA AVE",
"city": "CONNERSVILLE",
"state": "IN",
"postal_code": "473312833",
"telephone_number": "765-827-8052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "JONATHAN",
"name_prefix": "Mr.",
"credential": "MA, ATC, LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-26",
"last_updated": "2009-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36001185A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Connersville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.