Active NPI
Jamie Lynn Jolliffe, ATC
- Athletic Trainer
- Caldwell, ID
National Provider Identifier
1740614437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-503
- Practice address
- 2112 Cleveland Blvd
Athletics
Caldwell, ID 83605-4432 - Phone
- (208) 459-5052
- NPI assigned
- Aug 29, 2013
- 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 | AT-503 | ID | Primary |
Addresses
Primary practice location
2112 Cleveland Blvd
Athletics
Caldwell, ID 83605-4432
Mailing address
2792 S Lake Vista LN
Eagle, ID 83616-5421
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 |
|---|---|---|---|
| AT-503 | ID | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407369600000",
"number": "1740614437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2792 S LAKE VISTA LN",
"city": "EAGLE",
"state": "ID",
"postal_code": "836165421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2112 CLEVELAND BLVD",
"address_2": "ATHLETICS",
"city": "CALDWELL",
"state": "ID",
"postal_code": "836054432",
"telephone_number": "208-459-5052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLLIFFE",
"first_name": "JAMIE",
"middle_name": "LYNN",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-29",
"last_updated": "2014-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ID",
"license": "AT-503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caldwell, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.