Active NPI
Jack Cooney
- Athletic Trainer
- San Francisco, CA
National Provider Identifier
1538821350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 070702863
- Practice address
- 930 Cole St Ste 103
San Francisco, CA 94117-4367 - Phone
- (415) 841-2721
- NPI assigned
- Oct 8, 2021
- Last updated
- Oct 8, 2021
- 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 | 070702863 | CA | Primary |
Addresses
Primary practice location
930 Cole St Ste 103
San Francisco, CA 94117-4367
Mailing address
114 Clarendon Ave
San Francisco, CA 94114-2104
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070708623 | Other | CA | NATABBOC |
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 |
|---|---|---|---|
| 070702863 | CA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633651200000",
"number": "1538821350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 CLARENDON AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941142104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 COLE ST STE 103",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941174367",
"telephone_number": "415-841-2721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COONEY",
"first_name": "JACK",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-08",
"last_updated": "2021-10-08",
"certification_date": "2021-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CA",
"license": "070702863",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATABBOC",
"identifier": "070708623",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.