Active NPI
Jolie Garvin, LAT
- Athletic Trainer
- Roseville, MN
National Provider Identifier
1972193308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1812 Dale CT
Roseville, MN 55113-6538 - Phone
- (651) 328-4255
- NPI assigned
- Jan 20, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
1812 Dale CT
Roseville, MN 55113-6538
Mailing address
1812 Dale CT
Roseville, MN 55113-6538
Phone (651) 328-4255
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671667200000",
"number": "1972193308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1812 DALE CT",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551136538",
"telephone_number": "651-328-4255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1812 DALE CT",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551136538",
"telephone_number": "651-328-4255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARVIN",
"first_name": "JOLIE",
"credential": "LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-20",
"last_updated": "2022-12-22",
"certification_date": "2022-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.