Individual provider Active NPI

Rae Lynn Jurkash, MS, LAT, ATC

  • Athletic Trainer
  • Stuart, FL
National Provider Identifier
1891540845
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
5564 Issued in FL
Practice address
1050 SE Monterey Rd
Stuart, FL 34994-4512
Phone
(772) 403-2293
NPI assigned
Apr 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 5564 FL Primary

Addresses

Primary practice location

1050 SE Monterey Rd
Stuart, FL 34994-4512

Mailing address

2241 SW Lawrence St
Port St Lucie, FL 34953-2314
Phone (321) 505-7972

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5564FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1891540845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 SW LAWRENCE ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349532314",
            "telephone_number": "321-505-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 SE MONTEREY RD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944512",
            "telephone_number": "772-403-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURKASH",
        "first_name": "RAE",
        "middle_name": "LYNN",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "5564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.