Active NPI
Jacob Routhier
- Athletic Trainer
- Mesa, AZ
National Provider Identifier
1457017386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- ATR-008966
- Practice address
- 160 E Athletics Way
Mesa, AZ 85201-5068 - Phone
- (203) 258-1932
- NPI assigned
- Nov 15, 2021
- 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 | ATR-008966 | AZ | Primary |
Addresses
Primary practice location
160 E Athletics Way
Mesa, AZ 85201-5068
Mailing address
200 Pell Meadow Dr
Fairfield, CT 06824-2962
Phone (203) 258-1932
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 |
|---|---|---|---|
| ATR-008966 | AZ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1457017386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 PELL MEADOW DR",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068242962",
"telephone_number": "203-258-1932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 E ATHLETICS WAY",
"city": "MESA",
"state": "AZ",
"postal_code": "852015068",
"telephone_number": "203-258-1932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUTHIER",
"first_name": "JACOB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-15",
"last_updated": "2021-11-15",
"certification_date": "2021-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AZ",
"license": "ATR-008966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.