Active NPI
Timothy Jacques, ATC
- Athletic Trainer
- Agawam, MA
National Provider Identifier
1689624694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 760 Cooper St
Agawam, MA 01001-2177 - Phone
- (413) 246-2271
- NPI assigned
- May 11, 2006
- 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 | MA | Primary |
Addresses
Primary practice location
760 Cooper St
Agawam, MA 01001-2177
Mailing address
490 N West St
Feeding Hills, MA 01030-1029
Phone (413) 789-1851
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1689624694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "490 N WEST ST",
"city": "FEEDING HILLS",
"state": "MA",
"postal_code": "010301029",
"telephone_number": "413-789-1851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 COOPER ST",
"city": "AGAWAM",
"state": "MA",
"postal_code": "010012177",
"telephone_number": "413-246-2271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACQUES",
"first_name": "TIMOTHY",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Agawam, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.