Individual provider Active NPI

Jerome N Joseph, CERTIFIED

  • Athletic Trainer
  • Lehigh Acres, FL
National Provider Identifier
1821643099
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
3108 6TH St W
Lehigh Acres, FL 33971-1460
Phone
(239) 491-4700
Fax
(877) 836-4662
NPI assigned
Aug 5, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X
Athletic Trainer 2255A2300X FL Primary

Addresses

Primary practice location

3108 6TH St W
Lehigh Acres, FL 33971-1460

Mailing address

3108 6TH St W
Lehigh Acres, FL 33971-1460
Phone (239) 491-4700

Other identifiers 1

IdentifierTypeStateIssuer
XXXOtherFLACE

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL JEBSADVERTISING@OUTLOOK.COM JOEANNETHOMASJOSEPH - JEBS CONSULTANTS
Direct Messaging Address JEBSADVERTISING@OUTLOOK.COM Direct JOEANNETHOMASJOSEPH - JEBS CONSULTANTS

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

Practice roles

OrganizationSpecialtyStatusNew patients
Joeannethomasjoseph - Jebs Consultants Athletic Trainer CurrentSince Aug 11, 2019 Accepting new patients
Joeannethomasjoseph Company CurrentSince Aug 11, 2019 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1821643099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 6TH ST W",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711460",
            "telephone_number": "239-491-4700",
            "fax_number": "877-836-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 6TH ST W",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711460",
            "telephone_number": "239-491-4700",
            "fax_number": "877-836-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "JEROME",
        "middle_name": "N",
        "credential": "CERTIFIED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-05",
        "last_updated": "2023-11-27",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACE",
            "identifier": "XXX",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "JEBSADVERTISING@OUTLOOK.COM",
            "affiliation": "Y",
            "affiliationName": "JOEANNETHOMASJOSEPH - JEBS CONSULTANTS",
            "address_1": "3108 6th St W",
            "city": "Lehigh Acres",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339711460",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JEBSADVERTISING@OUTLOOK.COM",
            "affiliation": "Y",
            "affiliationName": "JOEANNETHOMASJOSEPH - JEBS CONSULTANTS",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3108 6th St W",
            "city": "Lehigh Acres",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339711460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.