Active NPI
Jessica Zaccour, ATC
- Athletic Trainer
- Cheektowaga, NY
National Provider Identifier
1982215943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 003021
- Practice address
- 4225 Genesee St
Cheektowaga, NY 14225-1994 - Phone
- (716) 204-3200
- NPI assigned
- Aug 13, 2020
- 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 | 003021 | NY | Primary |
Addresses
Primary practice location
4225 Genesee St
Cheektowaga, NY 14225-1994
Mailing address
4225 Genesee St
Cheektowaga, NY 14225-1994
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 56504 | Other | NATA | |
| 2000020808 | Other | BOC ATC |
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 |
|---|---|---|---|
| 003021 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597276800000",
"number": "1982215943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4225 GENESEE ST",
"city": "CHEEKTOWAGA",
"state": "NY",
"postal_code": "142251994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4225 GENESEE ST",
"city": "CHEEKTOWAGA",
"state": "NY",
"postal_code": "142251994",
"telephone_number": "716-204-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZACCOUR",
"first_name": "JESSICA",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-13",
"last_updated": "2020-08-13",
"certification_date": "2020-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "003021",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATA",
"identifier": "56504",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOC ATC",
"identifier": "2000020808",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Cheektowaga, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.