Jaclyn Clauson, MM, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2014027293 Issued in MO

Practice address

2800 W Main St
Belleville, IL 62226-6612

Phone

(320) 226-4377

NPI assigned

May 23, 2016

Last updated

Aug 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1669829347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8501 W 22ND ST APT 309",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571068482",
            "telephone_number": "320-226-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 W MAIN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622266612",
            "telephone_number": "320-226-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAUSON",
        "first_name": "JACLYN",
        "credential": "MM, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2014027293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Ciampoli, CRNA
• Danielle Clark
• Hope Clark
• Clarkson Optometry Illinois PC
• Cassandra Jolene Claro
• Misty Jo Clemens, M.A., LCPC
• Stephen J Clement, R.PH.
• Clinical Radiologists, S.C.
• James Michael Coder, PHARMD
• Erica Coleman

• Athletic Trainer in Belleville, IL
• Providers in Belleville, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.