Active NPI
Jason Kluckhohn, ATC, SCAT
- Athletic Trainer
- Greenville, SC
National Provider Identifier
1427465715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 384
- Practice address
- 200 Patewood Dr Ste B170
Greenville, SC 29615-6335 - Phone
- (864) 420-7627
- NPI assigned
- Jul 18, 2014
- Last updated
- Jul 18, 2014
- 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 | 384 | SC | Primary |
Addresses
Primary practice location
200 Patewood Dr Ste B170
Greenville, SC 29615-6335
Mailing address
225 Ballyhoo CT
Greer, SC 29651-4914
Phone (864) 420-7627
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 |
|---|---|---|---|
| 384 | SC | MD | Pulmonary Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405641600000",
"number": "1427465715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 BALLYHOO CT",
"city": "GREER",
"state": "SC",
"postal_code": "296514914",
"telephone_number": "864-420-7627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 PATEWOOD DR STE B170",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296156335",
"telephone_number": "864-420-7627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLUCKHOHN",
"first_name": "JASON",
"credential": "ATC, SCAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-18",
"last_updated": "2014-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SC",
"license": "384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.