JACK THOMAS EGNATZ
NPI 1619786704
Student in an Organized Health Care Education/Training Program in Bloomington, IN

Q: What is Jack Egnatz's NPI number?

The NPI number for Jack Egnatz is 1619786704. It was assigned to this individual provider in the NPPES registry on January 2, 2025.

Q: What is Jack Egnatz's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Egnatz was last updated on January 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 02, 2025

281 W 11TH ST, BLOOMINGTON, IN 47404(219) 798-5636 Get Directions Write a Review

NPPES record last updated: January 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jack Thomas Egnatz NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK THOMAS EGNATZ (NPI 1619786704) is an individual student in an organized health care education/training program in Bloomington, Indiana and active in the NPI registry since January 2025.

NPPES Registry Identity

NPI1619786704

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJACK THOMAS EGNATZ

Location Address281 W 11TH STBloomington, IN 47404-3718

Mailing Address281 W 11th StBloomington, IN 47404-3718 · (219) 798-5636

Phone(219) 798-5636

Sole ProprietorNo

Enumeration DateJanuary 2, 2025

NPPES CertifiedJanuary 2, 2025

✔ NPI 1619786704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

281 W 11TH ST, Bloomington, IN 47404

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES C GULLETT

Student in an Organized Health Care Education/Training Program

281 W 11TH ST
BLOOMINGTON, IN 47404

Monroe County (979) 777-4957

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Egnatz's NPI number?

The NPI number for Jack Egnatz is 1619786704. It was assigned to this individual provider in the NPPES registry on January 2, 2025.

Where is Jack Egnatz located?

Jack Egnatz practices at 281 W 11th St, Bloomington, IN 47404. The listed phone number is (219) 798-5636.

What is Jack Egnatz's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Jack Egnatz was last updated on January 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.