Active NPI
Taryn Wellborn, L.A.T.
- Athletic Trainer
- Jacksonville, FL
National Provider Identifier
1942740824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL4750
- Practice address
- 9726 Touchton Rd
Jacksonville, FL 32246-8304 - Phone
- (904) 421-1221
- NPI assigned
- Feb 27, 2017
- Sex
- Female
- 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 | AL4750 | FL | Primary |
Addresses
Primary practice location
9726 Touchton Rd
Jacksonville, FL 32246-8304
Mailing address
9726 Touchton Rd
Jacksonville, FL 32246-8304
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 |
|---|---|---|---|
| AL4750 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488153600000",
"number": "1942740824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9726 TOUCHTON RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322468304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9726 TOUCHTON RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322468304",
"telephone_number": "904-421-1221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLBORN",
"first_name": "TARYN",
"credential": "L.A.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-27",
"last_updated": "2017-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL4750",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.