Individual provider Active NPI

Jamal Cort, ATC

  • Athletic Trainer
  • Daytona Beach, FL
National Provider Identifier
1790175339
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL4042 Issued in FL
Practice address
1026 Indian Oaks W
Daytona Beach, FL 32117-3114
Phone
(347) 267-1237
NPI assigned
Feb 4, 2015
Last updated
Feb 4, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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 AL4042 FL Primary

Addresses

Primary practice location

1026 Indian Oaks W
Daytona Beach, FL 32117-3114

Mailing address

1026 Indian Oaks W
Daytona Beach, FL 32117-3114
Phone (347) 267-1237

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
AL4042FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1790175339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 INDIAN OAKS W",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321173114",
            "telephone_number": "347-267-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 INDIAN OAKS W",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321173114",
            "telephone_number": "347-267-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORT",
        "first_name": "JAMAL",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-04",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL4042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; 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.