Active NPI
Jordan Thomas Eshbaugh, AT
- Athletic Trainer
- Englewood, OH
National Provider Identifier
1639820889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT.004941
- Practice address
- 9000 N Main St
Englewood, OH 45415-1180 - Phone
- (937) 734-5853
- NPI assigned
- Jan 10, 2022
- 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 | AT.004941 | OH | Primary |
Addresses
Primary practice location
9000 N Main St
Englewood, OH 45415-1180
Mailing address
4916 National Rd
Clayton, OH 45315-9705
Phone (937) 832-6048
Other practice location 1
4916 National Rd
Clayton, OH 45315-9705
Phone (937) 832-6048
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AT.004941 | Other | OH | STATE LICENSURE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jteshbaugh@premierhealth.com | Direct |
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 |
|---|---|---|---|
| AT.004941 | OH | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641772800000",
"number": "1639820889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4916 NATIONAL RD",
"city": "CLAYTON",
"state": "OH",
"postal_code": "453159705",
"telephone_number": "937-832-6048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 N MAIN ST",
"city": "ENGLEWOOD",
"state": "OH",
"postal_code": "454151180",
"telephone_number": "937-734-5853"
}
],
"practiceLocations": [
{
"address_1": "4916 National Rd",
"address_purpose": "LOCATION",
"city": "Clayton",
"state": "OH",
"postal_code": "453159705",
"country_code": "US",
"telephone_number": "937-832-6048",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ESHBAUGH",
"first_name": "JORDAN",
"middle_name": "THOMAS",
"credential": "AT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-10",
"last_updated": "2022-01-10",
"certification_date": "2021-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "AT.004941",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSURE",
"identifier": "AT.004941",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jteshbaugh@premierhealth.com",
"affiliation": "N",
"endpointDescription": "Professional Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "9000 N Main St",
"city": "Englewood",
"state": "OH",
"country_code": "US",
"postal_code": "454151180",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Englewood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.