Individual provider Active NPI

Jana L. Rickard, AT-C

  • Athletic Trainer
  • Kennesaw, GA
National Provider Identifier
1629030531
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT001101 Issued in GA
Practice address
270 Chastain Rd NW
Kennesaw, GA 30144-3012
Phone
(678) 594-6080
Fax
(678) 594-6081
NPI assigned
Apr 5, 2006
Last updated
Apr 8, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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 AT001101 GA Primary

Addresses

Primary practice location

270 Chastain Rd NW
Kennesaw, GA 30144-3012

Mailing address

270 Chastain Rd NW
Kennesaw, GA 30144-3012
Phone (678) 594-6080

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
AT001101GAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1629030531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 CHASTAIN RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443012",
            "telephone_number": "678-594-6080",
            "fax_number": "678-594-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 CHASTAIN RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443012",
            "telephone_number": "678-594-6080",
            "fax_number": "678-594-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKARD",
        "first_name": "JANA",
        "middle_name": "L.",
        "credential": "AT-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT001101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.