Active NPI
Jennifer Nixon, ATC
- Athletic Trainer
- Spartanburg, SC
National Provider Identifier
1740700905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1642
- Practice address
- 151 Ribault St Ste 200
Spartanburg, SC 29302-2630 - Phone
- (646) 996-3138
- NPI assigned
- Jun 20, 2017
- 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 | 1642 | SC | Primary |
Addresses
Primary practice location
151 Ribault St Ste 200
Spartanburg, SC 29302-2630
Mailing address
608 N Brown Beaver CT
Moore, SC 29369-9296
Phone (646) 996-3138
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 |
|---|---|---|---|
| 1642 | SC | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497916800000",
"number": "1740700905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "608 N BROWN BEAVER CT",
"city": "MOORE",
"state": "SC",
"postal_code": "293699296",
"telephone_number": "646-996-3138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 RIBAULT ST STE 200",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293022630",
"telephone_number": "646-996-3138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIXON",
"first_name": "JENNIFER",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-20",
"last_updated": "2017-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SC",
"license": "1642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spartanburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.