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Active NPI 1629695663 Individual Practitioner Male Practitioner

Jacob Alan Clark , MS, LAT, ATC

Specialist/Technologist - Athletic Trainer • Cisco, TX

Professional Overview & Biography Verified Profile Summary

Jacob Clark, MS, LAT, ATC is a registered healthcare professional specializing in Specialist/Technologist - Athletic Trainer in Cisco, TX. Practice services are available at 101 COLLEGE HTS under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

101 College Hts

Cisco, TX 764371900

Telephone 2544425198

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist/Technologist - Athletic Trainer in Cisco, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 7.0 Yrs
Regional Practice Density
4 Specialists

Practicing in Cisco, TX (3033 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-06-25
Specialist/Technologist - Athletic Trainer Primary Specialty

NUCC Taxonomy Code: 2255A2300X

State License TX AT8111

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Bluecross Blueshield
JEA013107880 (TX)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Michael Garcia , LAT

Specialist/Technologist - Athletic Trainer

NPI 1487620019

Licensed Athletic Trainer

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 25, 2020

NPI status registered as active in NPPES database

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Updated Practice Location June 25, 2020

Registered at 101 COLLEGE HTS, CISCO, TX 764371900 (Tel: 2544425198)

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Updated Business Mailing Address June 25, 2020

Registered at 1645 PR 2431, CLYDE, TX 795101900 (Tel: 4094892284)

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Provider Name / Credentials Updated June 25, 2020

Recorded as JACOB CLARK, MS, LAT, ATC

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 25, 2020

Specialist/Technologist (License #AT8111 in TX)

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Initial NPI Registration & Enumeration June 25, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1629695663
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 25, 2020
Last Update: June 25, 2020
Sole Proprietor: Yes

Mailing Address

1645 Pr 2431

Clyde, TX 795101900

Phone: 4094892284

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.