Jesse Wade McIntyre, DAT, LAT, ATC, CSCS

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT7626 Issued in TX

Practice address

210 La Salle Dr
San Angelo, TX 76903-7916

Phone

(405) 614-2024

NPI assigned

Oct 1, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1506816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1477063725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 LA SALLE DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769037916",
            "telephone_number": "405-614-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LA SALLE DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769037916",
            "telephone_number": "405-614-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "JESSE",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "DAT, LAT, ATC, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-01",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT7626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TDLR",
            "identifier": "AT7626",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillian Jae McGee, RN
• Carl Dee McGill, DDS
• Sean McGill, M.D.
• Calvin Ogden McGowan, M.D.
• Mary Allison McGuire, SLP
• Shelby McIntyre, APRN
• Bradley McIver, MD
• Anna Catherine McKenzie
• Clinton McKenzie
• Emily Christine McKenzie, LCDC

• Athletic Trainer in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.