Individual provider Active NPI

Jamey Rasberry

  • Athletic Trainer
  • Lake Charles, LA
National Provider Identifier
1770932022
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
J00328 Issued in LA
Practice address
2322 Regena Dr
Lake Charles, LA 70611-4538
Phone
(337) 309-9409
NPI assigned
Jun 8, 2016
Last updated
Jun 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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 J00328 LA Primary

Addresses

Primary practice location

2322 Regena Dr
Lake Charles, LA 70611-4538

Mailing address

2322 Regena Dr
Lake Charles, LA 70611-4538
Phone (337) 309-9409

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
J00328LAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1770932022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2322 REGENA DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706114538",
            "telephone_number": "337-309-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2322 REGENA DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706114538",
            "telephone_number": "337-309-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASBERRY",
        "first_name": "JAMEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-08",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "LA",
            "license": "J00328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.