Active NPI
Amber Louise Harrell, ATC
- Athletic Trainer
- Jacksonville, FL
National Provider Identifier
1669998720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL5023
- Practice address
- 1700 Old Middleburg Rd N
Jacksonville, FL 32210-1232 - Phone
- (904) 693-7620
- NPI assigned
- Aug 20, 2017
- Sex
- Female
- 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 | AL5023 | FL | Primary |
Addresses
Primary practice location
1700 Old Middleburg Rd N
Jacksonville, FL 32210-1232
Mailing address
2194 Club Lake Dr
Orange Park, FL 32065-4600
Phone (904) 537-2836
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 |
|---|---|---|---|
| AL5023 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503187200000",
"number": "1669998720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2194 CLUB LAKE DR",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320654600",
"telephone_number": "904-537-2836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 OLD MIDDLEBURG RD N",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322101232",
"telephone_number": "904-693-7620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "AMBER",
"middle_name": "LOUISE",
"name_prefix": "Ms.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-20",
"last_updated": "2017-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL5023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.