Active NPI
Jennifer Macfadyen, ATC, LAT
- Athletic Trainer
- Manhattan, KS
National Provider Identifier
1720568025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 24-00829
- Practice address
- 1324 Lovers Lane
Justin Hall 240
Manhattan, KS 66506 - Phone
- (785) 532-0466
- NPI assigned
- Aug 16, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 24-00829 | KS | Primary |
Addresses
Primary practice location
1324 Lovers Lane
Justin Hall 240
Manhattan, KS 66506
Mailing address
312 Knoxberry Dr
Manhattan, KS 66502-7609
Phone (630) 712-5366
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22 | Other | KS | RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS |
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 |
|---|---|---|---|
| 24-00829 | KS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534377600000",
"number": "1720568025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 KNOXBERRY DR",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665027609",
"telephone_number": "630-712-5366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1324 LOVERS LANE",
"address_2": "JUSTIN HALL 240",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "66506",
"telephone_number": "785-532-0466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACFADYEN",
"first_name": "JENNIFER",
"credential": "ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-16",
"last_updated": "2018-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "KS",
"license": "24-00829",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS",
"identifier": "22",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manhattan, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.