Jason Taylor, ATC, CSCS
Individual provider Active NPI Athletic Trainer · Mt Sterling, IL
NPI 1417519141 · NPPES record last updated Jul 2, 2019
Key facts
- NPI
- 1417519141
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 1 Dot Way
Mt Sterling, IL 62353-1664 - Phone
- (217) 773-4411
- NPI assigned
- Jul 2, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
1 Dot Way
Mt Sterling, IL 62353-1664
Mailing address
27 Avian Dr
East Greenbush, NY 12061-4128
Phone (518) 322-8080
Other providers in Mt Sterling, IL
- Nicholas Skinner
- Kayla Mae Smith
- Sarah Elaine Smith
- Jasmine Sommer
- Beth Stephens
- Jonathon Paul Thoele
- Lindsey Nicole Wagner
- Khalid Waheed
- Madeline Nichole Weber
- Wendy Wegs
All providers in Mt Sterling, IL · Athletic Trainer in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.