Active NPI
Jacob Kintz, ATC, LAT
- Athletic Trainer
- Springfield, MO
National Provider Identifier
1942746284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2016028027
- Practice address
- 623 E Montclair St
Apt 3B
Springfield, MO 65807-8932 - Phone
- (417) 865-2815
- NPI assigned
- Jan 10, 2017
- Last updated
- Jan 10, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 | 2016028027 | MO | Primary |
Addresses
Primary practice location
623 E Montclair St
Apt 3B
Springfield, MO 65807-8932
Mailing address
623 E Montclair St
Apt 3B
Springfield, MO 65807-8932
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 |
|---|---|---|---|
| 2016028027 | MO | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484006400000",
"number": "1942746284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "623 E MONTCLAIR ST",
"address_2": "APT 3B",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658078932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "623 E MONTCLAIR ST",
"address_2": "APT 3B",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658078932",
"telephone_number": "417-865-2815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINTZ",
"first_name": "JACOB",
"credential": "ATC, LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-10",
"last_updated": "2017-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MO",
"license": "2016028027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
- Robert Allen King II, PSYD
- Wendy King, PHARMD
- Courtney Kinney, MSW, LCSW
- Joann Kinsey, LCSW
- Sheryl Lynn Kinsey, M.ED, LPC
- Lacey L Kinzer, MS, LPC
- Kirby J. Robinson, DDS of Missouri, LLC (Affordable Dentures & Implants - Springfield)
- Janelle Kirila, M.S., A.T.C, L.A.T
- Sarah E Kirk, PT,DPT
- Spencer Park Kirk, D.O.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.