Jacob Daniel Pszanka, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

092973 Issued in IA

Practice address

203 Wellness and Recreation Center
Cedar Falls, IA 50614-0001

Phone

(319) 273-2654

NPI assigned

Mar 11, 2020

Last updated

Mar 11, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1851926729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 FREDRICK AVE",
            "city": "CLEMONS",
            "state": "IA",
            "postal_code": "500519637",
            "telephone_number": "641-485-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 WELLNESS AND RECREATION CENTER",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506140001",
            "telephone_number": "319-273-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PSZANKA",
        "first_name": "JACOB",
        "middle_name": "DANIEL",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "092973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Cedar Falls, IA
• Providers in Cedar Falls, IA by specialty
• Athletic Trainer in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.

Verify at the official NPI Registry.