Active NPI
Jennifer Sturtevant, LATC
- Athletic Trainer
- Medford, MA
National Provider Identifier
1689796492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1517
- Practice address
- 101 Main St
Suite 105
Medford, MA 02155-4540 - Phone
- (781) 395-7750
- Fax
- (781) 395-5343
- NPI assigned
- Apr 4, 2007
- 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 | 1517 | MA | Primary |
Addresses
Primary practice location
101 Main St
Suite 105
Medford, MA 02155-4540
Mailing address
6 Lakeshore Ave
Beverly, MA 01915-1908
Phone (617) 827-5311
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 |
|---|---|---|---|
| 1517 | MA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490659200000",
"number": "1689796492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 LAKESHORE AVE",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019151908",
"telephone_number": "617-827-5311",
"fax_number": "781-395-5343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 MAIN ST",
"address_2": "SUITE 105",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021554540",
"telephone_number": "781-395-7750",
"fax_number": "781-395-5343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STURTEVANT",
"first_name": "JENNIFER",
"name_prefix": "Ms.",
"credential": "LATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2017-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "1517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.