Individual provider Active NPI

Jared D Braverman, ATC

  • Athletic Trainer
  • Germantown, MD
National Provider Identifier
1720413404
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
A0000471 Issued in MD
Practice address
20410 Century Blvd
Medstar NRH Rehab Network - #215
Germantown, MD 20874-1186
Phone
(301) 540-6140
Fax
(301) 540-5190
NPI assigned
Sep 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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 A0000471 MD Primary

Addresses

Primary practice location

20410 Century Blvd
Medstar NRH Rehab Network - #215
Germantown, MD 20874-1186

Mailing address

20410 Century Blvd
Medstar NRH Rehab Network - #215
Germantown, MD 20874-1186
Phone (301) 540-6140

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
A0000471MDMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1720413404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20410 CENTURY BLVD",
            "address_2": "MEDSTAR NRH REHAB NETWORK - #215",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741186",
            "telephone_number": "301-540-6140",
            "fax_number": "301-540-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20410 CENTURY BLVD",
            "address_2": "MEDSTAR NRH REHAB NETWORK - #215",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741186",
            "telephone_number": "301-540-6140",
            "fax_number": "301-540-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVERMAN",
        "first_name": "JARED",
        "middle_name": "D",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-12",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0000471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.