Individual provider Active NPI

Jeffrey Pierce

  • Athletic Trainer
  • Indianapolis, IN
National Provider Identifier
1487122966
Registry record updated Nov 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
36002036A Issued in IN
Practice address
7802 Hague Rd
Indianapolis, IN 46256-1754
Phone
(317) 946-1034
NPI assigned
Nov 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 36002036A IN Primary

Addresses

Primary practice location

7802 Hague Rd
Indianapolis, IN 46256-1754

Mailing address

4553 Andover Pkwy
Westfield, IN 46062-9343

Other practice location 1

4553 Andover Pkwy
Westfield, IN 46062-9343
Phone (317) 946-1034

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

LicenseStateTypeSpecialty
36002036AINMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1487122966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4553 ANDOVER PKWY",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460629343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7802 HAGUE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561754",
            "telephone_number": "317-946-1034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4553 Andover Pkwy",
            "address_purpose": "LOCATION",
            "city": "Westfield",
            "state": "IN",
            "postal_code": "460629343",
            "country_code": "US",
            "telephone_number": "317-946-1034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "JEFFREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-02",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36002036A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; 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.