Jade Wanger, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

3514 Issued in MA

Practice address

282 Farmers Row
Groton, MA 01450-1848

Phone

(978) 448-3363

NPI assigned

May 21, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1463788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610755200000",
    "number": "1801243605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 THINGVALLA AVE",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024783668",
            "telephone_number": "608-220-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 FARMERS ROW",
            "city": "GROTON",
            "state": "MA",
            "postal_code": "014501848",
            "telephone_number": "978-448-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANGER",
        "first_name": "JADE",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-21",
        "last_updated": "2021-01-16",
        "certification_date": "2021-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT002077",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "3514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Harrison Valli, DMD
• Frank Joseph Vangeli, LICSW
• Margaret Jane Vangeli, LICSW
• Paula Christian Vaughan, PA-C
• John Thomas Walsh, LMHC
• Elizabeth Warncke
• Hilde Hamar Westvik, MD
• Bethany Joan Whitefield
• Shawna Lynn Young, MA, CCC-SLP
• James Yovino, RPH

• Athletic Trainer in Groton, MA
• Providers in Groton, MA by specialty
• Athletic Trainer in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2021; 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.