Active NPI
Deborah Jenks, LAT
- Athletic Trainer
- Madison, WI
National Provider Identifier
1740698489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 405-39
- Practice address
- 2501 W Beltline Hwy
Suite 601
Madison, WI 53713-2318 - Phone
- (608) 288-6432
- NPI assigned
- Jul 25, 2014
- 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 | 405-39 | WI | Primary |
Addresses
Primary practice location
2501 W Beltline Hwy
Suite 601
Madison, WI 53713-2318
Mailing address
430 Orchard Dr
Oregon, WI 53575-1226
Phone (608) 692-7912
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 |
|---|---|---|---|
| 405-39 | WI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406246400000",
"number": "1740698489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 ORCHARD DR",
"city": "OREGON",
"state": "WI",
"postal_code": "535751226",
"telephone_number": "608-692-7912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 W BELTLINE HWY",
"address_2": "SUITE 601",
"city": "MADISON",
"state": "WI",
"postal_code": "537132318",
"telephone_number": "608-288-6432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKS",
"first_name": "DEBORAH",
"name_prefix": "Miss",
"credential": "LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-25",
"last_updated": "2014-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "405-39",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.