Active NPI
Shaylyn Novak, ATC, LAT
- Athletic Trainer
- Princeton, NJ
National Provider Identifier
1417589987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 25MT00227800
- Practice address
- 650 Great Rd
Princeton, NJ 08540-2598 - Phone
- (609) 924-6700
- NPI assigned
- Feb 12, 2020
- Last updated
- Feb 12, 2020
- 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 | 25MT00227800 | NJ | Primary |
Addresses
Primary practice location
650 Great Rd
Princeton, NJ 08540-2598
Mailing address
119 Barricklo St
Hamilton, NJ 08610-6507
Phone (609) 337-0964
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
| License | State | Type | Specialty |
|---|---|---|---|
| 25MT00227800 | NJ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581465600000",
"number": "1417589987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 BARRICKLO ST",
"city": "HAMILTON",
"state": "NJ",
"postal_code": "086106507",
"telephone_number": "609-337-0964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 GREAT RD",
"city": "PRINCETON",
"state": "NJ",
"postal_code": "085402598",
"telephone_number": "609-924-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVAK",
"first_name": "SHAYLYN",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-12",
"last_updated": "2020-02-12",
"certification_date": "2020-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NJ",
"license": "25MT00227800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Princeton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.