Active NPI
Robert Jadgchew
- Athletic Trainer
- Virginia Beach, VA
National Provider Identifier
1568841880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0126001769
- Practice address
- 427 Polaris Avenue
BLDG 586
Virginia Beach, VA 23461 - Phone
- (757) 862-0085
- NPI assigned
- May 19, 2015
- 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 | 0126001769 | VA | Primary |
Addresses
Primary practice location
427 Polaris Avenue
BLDG 586
Virginia Beach, VA 23461
Mailing address
427 Polaris Avenue
BLDG 586
Virginia Beach, VA 23461
Phone (757) 862-0085
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0126001769 | Other | VA | DEPT OF HEALTH PROFESSIONALS BOARD OF MEDICINE |
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 |
|---|---|---|---|
| 0126001769 | VA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431993600000",
"number": "1568841880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "427 POLARIS AVENUE",
"address_2": "BLDG 586",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "23461",
"telephone_number": "757-862-0085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "427 POLARIS AVENUE",
"address_2": "BLDG 586",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "23461",
"telephone_number": "757-862-0085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JADGCHEW",
"first_name": "ROBERT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-19",
"last_updated": "2015-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "VA",
"license": "0126001769",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF HEALTH PROFESSIONALS BOARD OF MEDICINE",
"identifier": "0126001769",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.