Active NPI
Jesse Donnenwerth, LAT
- Athletic Trainer
- Iowa City, IA
National Provider Identifier
1528626306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 000965
- Practice address
- S-210 Carver-Hawkeye-Arena
Iowa City, IA 52242-5224 - Phone
- (319) 631-3228
- NPI assigned
- Jun 5, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 000965 | IA | Primary |
Addresses
Primary practice location
S-210 Carver-Hawkeye-Arena
Iowa City, IA 52242-5224
Mailing address
S-210 Carver-Hawkeye-Arena
Iowa City, IA 52242
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 |
|---|---|---|---|
| 000965 | IA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559692800000",
"number": "1528626306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "S-210 CARVER-HAWKEYE-ARENA",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "52242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "S-210 CARVER-HAWKEYE-ARENA",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522425224",
"telephone_number": "319-631-3228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONNENWERTH",
"first_name": "JESSE",
"credential": "LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-05",
"last_updated": "2019-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IA",
"license": "000965",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.