Individual provider Active NPI

Joshua Wolcott, LAT, ATC

  • Athletic Trainer
  • Jacksonville, FL
National Provider Identifier
1396478756
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
5471 Issued in FL
Practice address
948 Mineral Creek Dr
Jacksonville, FL 32225-5315
Phone
(813) 440-7257
NPI assigned
Jul 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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 5471 FL Primary

Addresses

Primary practice location

948 Mineral Creek Dr
Jacksonville, FL 32225-5315

Mailing address

6418 N Woodlynne Ave
Tampa, FL 33614-4611

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
5471FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1396478756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6418 N WOODLYNNE AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336144611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "948 MINERAL CREEK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322255315",
            "telephone_number": "813-440-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLCOTT",
        "first_name": "JOSHUA",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "5471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.