Jennifer K Popp, EDD, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

36000419A Issued in IN

Practice address

800 W Stadium Ave
West Lafayette, IN 47907

Phone

(765) 494-3167

NPI assigned

Oct 5, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Burris Laboratory School

  • Local Education Agency (LEA)
  • Muncie, IN
  • NPI 1407984107
  NPD (past)

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1437401130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W STADIUM AVE",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479072046",
            "telephone_number": "765-494-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W STADIUM AVE",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "47907",
            "telephone_number": "765-494-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPP",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "credential": "EDD, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-05",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36000419A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tama Plumb
• Gabriela Kaye Poalino, LAT, ATC
• Angela Marie Polmateer, OTR
• Alexa Pontillo, APRN
• Mary L Poole, MS
• Kimberly Ann Pauline Porter
• Maycie Porter, NREMT
• Kaitlin Posey, LAT, ATC
• Katelyn Posey, PT, DPT, LAT, ATC
• Dawnita G Posso, LCSW

• Athletic Trainer in West Lafayette, IN
• Providers in West Lafayette, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; 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.