Shari Szucs Jacobson, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0126003592 Issued in VA

Practice address

5220 Cedar Dr
Usaf Academy, CO 80840-3299

Phone

(734) 355-1339

NPI assigned

Oct 7, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1407497886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 CEDAR DR",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808403299",
            "telephone_number": "734-355-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 CEDAR DR",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808403299",
            "telephone_number": "734-355-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "SHARI",
        "middle_name": "SZUCS",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126003592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyetus Hohnstein, DDS
• Tracy Hoover, AUD
• Scott C. Hughes
• Holly R Ingram, DO
• Jonathan Clayton Jackson, M.D.
• Brett Jessen
• Hillary Shea Johnson, PHARMD
• Kellie Ann Jones, DMD
• Brian Robert Kennedy, DNP
• David A Kephart Jr., D.O.

• Athletic Trainer in Usaf Academy, CO
• Providers in Usaf Academy, CO by specialty
• Athletic Trainer in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.