Active NPI
Jordan Elizabeth Blough, ATC
- Athletic Trainer
- Jefferson, LA
National Provider Identifier
1982190591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- ATH.200209
- Practice address
- 1201 S Clearview Pkwy
Jefferson, LA 70121-1015 - Phone
- (504) 736-4800
- NPI assigned
- Jul 6, 2018
- 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 | ATH.200209 | LA | Primary |
Addresses
Primary practice location
1201 S Clearview Pkwy
Jefferson, LA 70121-1015
Mailing address
1212 Focis St
Metairie, LA 70005-2318
Phone (941) 356-7483
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 |
|---|---|---|---|
| ATH.200209 | LA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530835200000",
"number": "1982190591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 FOCIS ST",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700052318",
"telephone_number": "941-356-7483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 S CLEARVIEW PKWY",
"city": "JEFFERSON",
"state": "LA",
"postal_code": "701211015",
"telephone_number": "504-736-4800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOUGH",
"first_name": "JORDAN",
"middle_name": "ELIZABETH",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-06",
"last_updated": "2018-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "LA",
"license": "ATH.200209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jefferson, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.