Mary E Jacobs, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

36000359A Issued in IN

Practice address

4201 S Washington St
Marion, IN 46953-4974

Phone

(765) 677-1675

Fax

(765) 677-1676

NPI assigned

Sep 9, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Indiana Wesleyan University

  • Student Health Clinic/Center
  • Marion, IN
  • NPI 1558491894
  NPD (past)

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1801880414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 W OVERLOOK RD",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469521120",
            "telephone_number": "765-677-1675",
            "fax_number": "765-677-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 S WASHINGTON ST",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469534974",
            "telephone_number": "765-677-1675",
            "fax_number": "765-677-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36000359A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chau N. Jackson, AGPCNP-BC
• Leslie Jackson, OTD, OTR/L
• Logan Jackson, RBT
• Tracy Jackson, NP
• Karen J Jacobs, D.O.
• Isabella Jarrell, RBT
• Cassadi Jasay
• Stephen Jasinski, MD
• Brittney Ann Jaynes, RBT
• Amara Jeffries, RBT

• Athletic Trainer in Marion, IN
• Providers in Marion, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.