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Jackson Wade Mcqueen , ATC

Specialist/Technologist - Athletic Trainer β€’ Phoenix, AZ

Active NPI 1780341032 Individual Practitioner Male Practitioner
Practice location in NPPES

3300 W Camelback Rd # A21367
Phoenix, AZ 850173030

Call 3259771914 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3300 W Camelback Rd # A21367

Phoenix, AZ 850173030

Telephone 3259771914
Other Listings in Public Data

NPPES lists 1 additional practice-address record in Dallas, TX. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2021

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Phoenix and Arizona

142 active clinicians are listed under Specialist/Technologist - Athletic Trainer with a practice address in Phoenix, AZ (645 in Arizona).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Phoenix

0% of these 142 clinicians have the CMS telehealth indicator.

0% of these 142 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-01-03
Specialist/Technologist - Athletic Trainer Primary Specialty

NUCC Taxonomy Code: 2255A2300X

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.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Arizona Medical Board.
Look Up on State Board Site

Secondary Practice Locations

3000 Mountain View Pkwy

Dallas, TX 75211

Phone: 2103337100

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Business Mailing Address January 05, 2023

Registered at 214 PENROSE ST, SAN ANGELO, TX 769038638 (Tel: 3259771914)

πŸ‘€
Provider Name / Credentials Updated January 05, 2023

Recorded as JACKSON MCQUEEN, ATC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 05, 2023

Student in an Organized Health Care Education/Training Program

βœ…
NPI Profile Active November 22, 2021

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) November 22, 2021

Registered at 3300 W CAMELBACK RD # A21367, PHOENIX, AZ 850173030 (Tel: 3259771914)

πŸ“
Business Mailing Address (Initial Record) November 22, 2021

Registered at 3300 W CAMELBACK RD # A21367, PHOENIX, AZ 850173030

πŸ‘€
Provider Name / Credentials (Initial Record) November 22, 2021

Recorded as JACKSON MCQUEEN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 22, 2021

Specialist/Technologist

🟒
Initial NPI Registration & Enumeration November 22, 2021

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1780341032
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 22, 2021
Last Update: January 05, 2023
Sole Proprietor: Yes

Mailing Address

214 Penrose St

San Angelo, TX 769038638

Phone: 3259771914

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.