Jade Marie Cedeno, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2021034192 Issued in MO

Practice address

3950 Newman Rd
Joplin, MO 64801-1512

Phone

(417) 625-3156

NPI assigned

Sep 3, 2021

Sex

Female

Sole proprietor

No

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1447928486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 S HILLCREST AVE APT B302",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075615",
            "telephone_number": "951-526-3594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 NEWMAN RD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648011512",
            "telephone_number": "417-625-3156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEDENO",
        "first_name": "JADE",
        "middle_name": "MARIE",
        "credential": "MS, LAT,  ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2021034192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Joplin, MO
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.