Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob Kidwell

Individual provider Athletic Trainer · NPI 1184412546

Jacob Kidwell is an Athletic Trainer in Saint Louis, Missouri. Practices as a sole proprietor. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

5267 Brass Lantern Pl
Saint Louis, MO 63128-3501
Phone: (314) 347-9769
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X

Record details

NPI number1184412546
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 28, 2025
Last updated in NPPESApril 28, 2025
Certification dateApril 27, 2025
Mailing address5267 Brass Lantern Pl, Saint Louis, MO 63128-3501

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