Individual provider Active NPI

Jonell Pollarine, ATC

  • Athletic Trainer
  • Wyomissing, PA
National Provider Identifier
1700110954
Registry record updated Sep 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
RT003726 Issued in PA
Practice address
1350 Broadcasting Rd
Suite 201
Wyomissing, PA 19610-3229
Phone
(610) 685-7200
Fax
(610) 685-6700
NPI assigned
Sep 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT003726 PA Primary

Addresses

Primary practice location

1350 Broadcasting Rd
Suite 201
Wyomissing, PA 19610-3229

Mailing address

200 W Weis St
High School Athletics
Topton, PA 19562-1532
Phone (610) 682-5102

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

LicenseStateTypeSpecialty
RT003726PAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1700110954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W WEIS ST",
            "address_2": "HIGH SCHOOL ATHLETICS",
            "city": "TOPTON",
            "state": "PA",
            "postal_code": "195621532",
            "telephone_number": "610-682-5102",
            "fax_number": "610-682-5137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BROADCASTING RD",
            "address_2": "SUITE 201",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103229",
            "telephone_number": "610-685-7200",
            "fax_number": "610-685-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLARINE",
        "first_name": "JONELL",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-21",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT003726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; 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.