TIA JACKSON MS, LAT, ATC
NPI 1649725938
Specialist/Technologist - Athletic Trainer in Sturgeon Bay, WI

Q: What is Tia Jackson's NPI number?

The NPI number for Tia Jackson is 1649725938. It was assigned to this individual provider in the NPPES registry on August 17, 2016. The provider is also known as Tia Jandrin.

Q: What is Tia Jackson's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

Q: When was this NPI record last updated?

The NPPES record for Tia Jackson was last updated on February 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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 August 17, 2016

323 S 18TH AVE, STURGEON BAY, WI 54235(920) 746-0410 Get Directions Write a Review

NPPES record last updated: February 19, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 19, 2019, Aug 17, 2016 (2 updates tracked since 2016).

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About Tia Jackson Ms, Lat, Atc NPPES

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

TIA JACKSON MS, LAT, ATC (NPI 1649725938) is an individual athletic trainer provider in Sturgeon Bay, Wisconsin, licensed in Wisconsin (1559-39) and active in the NPI registry since August 2016. She maintains a secondary practice location in Menomonee Falls.

NPPES Registry Identity

NPI1649725938

Entity TypeIndividualFemale

Primary Taxonomy2255A2300X

Provider Legal NameTIA JACKSONCredential: MS, LAT, ATC

Location Address323 S 18TH AVESturgeon Bay, WI 54235-1401

Mailing Address323 S 18th AveSturgeon Bay, WI 54235-1401 · (920) 746-0410

Phone(920) 746-0410

Sole ProprietorNo

Enumeration DateAugust 17, 2016

Last NPPES UpdateFebruary 19, 20192 updates tracked since enumeration

✔ NPI 1649725938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2255A2300X

License✔ Licensed in WI · 1559-39

Definition

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.

323 S 18TH AVE, Sturgeon Bay, WI 54235

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Other Names 1

Former Name (1)Tia Jandrin

Secondary Practice Location 1

Location 1N91W15750 Falls PkwyMenomonee Falls, WI 53051-2301 · Phone (262) 532-1100

Other Providers at the Same Location NPPES 20

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

JESSICA J SKINNER RN, IBCLC

Registered Nurse (Lactation Consultant)