JEREMY KEITH KING (NPI# 1164939849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164939849 |
| Entity Type | Individual |
| Full Name | JEREMY KEITH KING |
| Credential | M.ED, LAT, ATC, ITAT |
| Practice Address |
360 Rebels Cir Blue Ridge GA 30513-8137 |
| Mailing Address |
184 Blackberry Ln Morganton GA 30560-3700 |
| Practice Telephone | 7064555134 |
| Practice Fax Number | 7066326552 |
| Mailing Telephone | 7064555134 |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2018-01-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT002001 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | NATION ATHLETIC TRAINERS' ASSOCIATION MEMBER NUMBER | 10001136 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235394685 | Jeremy Richard King | Dentist | 1293 E Mcandrews Rd, Medford, OR 97504-6103 | 2008-07-25 |
| 1235390907 | Jeremy David King | Optometrist | 15702 East Highway 9, Norman, OK 73026 | 2008-06-24 |
| 1932371093 | Jeremy Malcolm King | Dentist | 4005 Nicholson Dr, Apt #2613, Baton Rouge, LA 70808-8402 | 2008-03-29 |
| 1982728580 | Jeremy Drew King | Dentist | 1381 Johnny Johnson Drive, Brookhaven, MS 39601-9641 | 2007-03-19 |
| 1013982529 | Jeremy Alan King | Obstetrics & Gynecology | 2330 W Joppa Rd, Suite 301, Lutherville, MD 21093-4609 | 2006-02-18 |
| 1073599890 | Jeremy C King | Family Medicine | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2005-12-22 |
| 1770192973 | Jeremy King | Registered Nurse | Hwy 160 Mp 394.3, Kayenta, AZ 86033-0368 | 2020-07-24 |
| 1073000345 | Jeremy R King | Registered Nurse | 330 S Stillaguamish Ave, Arlington, WA 98223-1642 | 2018-04-22 |
| 1194229658 | Jeremy King | Student in an Organized Health Care Education/Training Program | 6850 Lake Nona Blvd, Orlando, FL 32827-7408 | 2018-03-20 |
| 1144731258 | Jeremy King | Counselor | 2195 3rd Ave, New York, NY 10035-3529 | 2017-10-16 |
| Street Address |
360 REBELS CIR |
| City | BLUE RIDGE |
| State | GA |
| Zip Code | 30513-8137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356804561 | Christine Gangwisch | Registered Nurse | 3855 Old Highway 5 Ste 110, Blue Ridge, GA 30513 | 2019-04-13 |
| 1013474659 | Ten Dental LLC | Dentist | 330 Progress Circle Ste C, Blue Ridge, GA 30513 | 2019-03-01 |
| 1932646262 | David Lee Durham | Pharmacist | 5679 Appalachian Highway, Blue Ridge, GA 30513 | 2017-01-25 |
| 1659754398 | Jordan Patton | Ophthalmology | 266 Orvin Lance Dr Ste 5, Blue Ridge, GA 30513 | 2015-06-30 |
| 1063824977 | Christy Russell | Pharmacist | 97 Commerce Drive, Blue Ridge, GA 30513 | 2014-05-27 |
| 1588008429 | Nathan William Kincaid | Surgery | 2855 Old Highway 5 Ste 108, Blue Ridge, GA 30513 | 2013-04-22 |
| 1972800175 | W. Max Couch, Jr., Dds, Mds, LLC | Dentist | 2714 East First Street, Blue Ridge, GA 30513 | 2011-02-24 |
| 1760792246 | Med-trans Corporation | Ambulance | 482 Mccaysville Industrial Dr, Blue Ridge, GA 30513 | 2010-10-18 |
| 1396924791 | Sue Ann Richardson | Chiropractor | 59 Mckinney, Blue Ridge, GA 30513 | 2007-11-01 |
| 1164554432 | Pruitthealth Home First, Inc. | Case Management | 6050 Appalachian Highway, Suite 4, Blue Ridge, GA 30513 | 2007-03-12 |
| Find all providers in zip 30513 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| 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. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922577808 | Ashley Nicole Watkins | Specialist/Technologist | 500 Watkins Rd, Blue Ridge, GA 30513-4134 | 2018-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455959 | Mary Lee Richardson | Specialist/Technologist | 1591 Glenn Pl Sw, Mableton, GA 30126-1170 | 2020-10-25 |
| 1295332914 | Cayla Mckeon | Specialist/Technologist | 11 W 11th St Apt 17, Columbus, GA 31901-4239 | 2020-10-06 |
| 1205442472 | Si'ara Washington Farris | Specialist/Technologist | 564 Hillandale Park Dr, Lithonia, GA 30058-8833 | 2020-09-22 |
| 1033723150 | Grant Pheil | Specialist/Technologist | 3523 Old Penia Rd, Cordele, GA 31015-7714 | 2020-09-04 |
| 1376157933 | Jesus E Aviles | Specialist/Technologist | 755 Battery Ave Se, Atlanta, GA 30339-3017 | 2020-09-01 |
| 1588276943 | Jaden T Harris | Specialist/Technologist | 2205 Moncrieff St, Augusta, GA 30906-8905 | 2020-08-18 |
| 1891306437 | Tinasia Smalls | Specialist/Technologist | 100 Woodland Dr Apt 1416, Statesboro, GA 30458-6365 | 2020-08-16 |
| 1407467590 | Samantha Jean Libby | Specialist/Technologist | 2550 Akers Mill Rd Se Apt F14, Atlanta, GA 30339-3271 | 2020-08-12 |
| 1083224224 | John Christopher Hamil | Specialist/Technologist | 812 S Park St Ste 1, Carrollton, GA 30117-4412 | 2020-08-03 |
| 1780294926 | Andrew Alcantar | Specialist/Technologist | 7340 Fairmount Hwy Se, Calhoun, GA 30701-4023 | 2020-08-03 |
| Find all providers with the same taxonomy | ||||
| City | BLUE RIDGE |
| Zip Code | 30513 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.