Individual provider Active NPI

Jason Andrew Cruickshank, A.T.C.

  • Athletic Trainer
  • Strongsville, OH
National Provider Identifier
1619005089
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT-1725 Issued in OH
Practice address
16761 Southpark Ctr
Sports Health Physical Therapy
Strongsville, OH 44136-9302
Phone
(440) 878-2500
Fax
(440) 878-3010
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 AT-1725 OH Primary

Addresses

Primary practice location

16761 Southpark Ctr
Sports Health Physical Therapy
Strongsville, OH 44136-9302

Mailing address

3528 Tuttle Ave
Cleveland, OH 44111-3029

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
AT-1725OHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619005089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3528 TUTTLE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441113029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16761 SOUTHPARK CTR",
            "address_2": "SPORTS HEALTH PHYSICAL THERAPY",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441369302",
            "telephone_number": "440-878-2500",
            "fax_number": "440-878-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUICKSHANK",
        "first_name": "JASON",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "A.T.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT-1725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Strongsville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.