Active NPI
Jeff M Spaulding, LAT
- Athletic Trainer
- Port Orchard, WA
National Provider Identifier
1801422753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- A160571096
- Practice address
- 425 Mitchell Ave
Port Orchard, WA 98366-4114 - Phone
- (253) 310-7953
- NPI assigned
- Mar 22, 2020
- Sex
- Male
- 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 | A160571096 | WA | Primary |
Addresses
Primary practice location
425 Mitchell Ave
Port Orchard, WA 98366-4114
Mailing address
425 Mitchell Ave
Port Orchard, WA 98366-4114
Phone (360) 874-5766
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 |
|---|---|---|---|
| A160571096 | WA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584835200000",
"number": "1801422753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 MITCHELL AVE",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983664114",
"telephone_number": "360-874-5766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 MITCHELL AVE",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983664114",
"telephone_number": "253-310-7953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPAULDING",
"first_name": "JEFF",
"middle_name": "M",
"credential": "LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-22",
"last_updated": "2020-03-22",
"certification_date": "2020-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WA",
"license": "A160571096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orchard, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.