JORDAN TEBODA (NPI# 1245693209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245693209 |
| Entity Type | Individual |
| Full Name | JORDAN TEBODA |
| Credential | ATC |
| Practice Address |
59 Executive Park S Atlanta GA 30329-2208 |
| Mailing Address |
8259 Wicker Ave Saint John IN 46373-8878 |
| Practice Telephone | 4047786330 |
| Practice Fax Number | 4047786370 |
| Mailing Telephone | 2193656560 |
| Mailing Fax Number | 2193656561 |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2016-03-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT002448 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
59 EXECUTIVE PARK S |
| City | ATLANTA |
| State | GA |
| Zip Code | 30329-2208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427054386 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 59 Executive Park S, Suite 1300, Atlanta, GA 30329-2208 | 2005-06-24 |
| 1174143275 | Alexander Ross Webb | Student in an Organized Health Care Education/Training Program | 59 Executive Park S, Atlanta, GA 30329-2208 | 2020-04-20 |
| 1275152019 | Haley Marie Mckissack | Student in an Organized Health Care Education/Training Program | 59 Executive Park S, Atlanta, GA 30329-2208 | 2020-04-12 |
| 1609405356 | Jason Shah | Student in an Organized Health Care Education/Training Program | 59 Executive Park S, Atlanta, GA 30329-2208 | 2020-04-05 |
| 1326693656 | Shatari Grimes | Occupational Therapist | 59 Executive Park S, Atlanta, GA 30329-2208 | 2019-08-05 |
| 1245798248 | Erin Dobeck | Nurse Practitioner | 59 Executive Park S, Atlanta, GA 30329-2208 | 2019-03-08 |
| 1548793185 | Huai Ming Phen | Student in an Organized Health Care Education/Training Program | 59 Executive Park S, Suite 2000, Atlanta, GA 30329-2208 | 2017-04-11 |
| 1598128092 | Heather Schmidt | Specialist/Technologist | 59 Executive Park S, Atlanta, GA 30329-2208 | 2016-04-01 |
| 1932562824 | Cherell Lawson | Specialist/Technologist | 59 Executive Park S, Atlanta, GA 30329-2208 | 2016-03-30 |
| 1366803959 | Rachel Zgrabik | Specialist/Technologist | 59 Executive Park S, Atlanta, GA 30329-2208 | 2016-03-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871084111 | Inner Peace Counseling Services,llc | Counselor | 2801 Bufford Highway, Suite T-10, Atlanta, GA 30329 | 2018-05-22 |
| 1912409392 | Joie De Vivre Counseling and Therapy | Counselor | 2801 Buford Highway, Ne, Atlanta, GA 30329 | 2018-03-01 |
| 1902329105 | Barbara Dunbar | Psychologist | 1777 Northeast Expressway, #175, Atlanta, GA 30329 | 2017-07-19 |
| 1114449048 | Cricket Cheyenne Gullickson | Student in an Organized Health Care Education/Training Program | 1371 Briarvista Way Ne, Atlanta, GA 30329 | 2017-07-12 |
| 1902357866 | Carla Zimmerly | Nurse Practitioner | 1711 Tullie Circle, Atlanta, GA 30329 | 2016-10-17 |
| 1316490808 | Shahzad Ghori | Student in an Organized Health Care Education/Training Program | 1727 Druid Oaks Ne, Atlanta, GA 30329 | 2016-08-01 |
| 1023467768 | Ashley Elliott | Physician Assistant | 59 Executive Park, Atlanta, GA 30329 | 2016-06-03 |
| 1285096115 | Kimberley Fox | Internal Medicine | 1600 Clifton Rd Ne, Ms A-04, Cdc, Atlanta, GA 30329 | 2016-03-21 |
| 1275991648 | Mary Patricia Joyce | Internal Medicine | 1600 Clifton Road, E-47, Centers for Disease Control and Prevention, Atlanta, GA 30329 | 2016-02-01 |
| 1346656618 | Amelia Muniz Hernandez | Pediatrics | 1841 Clifton Rd Ne # 508, Atlanta, GA 30329 | 2014-07-08 |
| Find all providers in zip 30329 | ||||
| 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 |
|---|---|---|---|---|
| 1376157933 | Jesus E Aviles | Specialist/Technologist | 755 Battery Ave Se, Atlanta, GA 30339-3017 | 2020-09-01 |
| 1407467590 | Samantha Jean Libby | Specialist/Technologist | 2550 Akers Mill Rd Se Apt F14, Atlanta, GA 30339-3271 | 2020-08-12 |
| 1063033033 | Katelynn Moore | Specialist/Technologist | 805 Mt Vernon Hwy Nw, Atlanta, GA 30327-4338 | 2020-04-30 |
| 1427689017 | Lorraine Kelly Mccall | Specialist/Technologist | 2241 Jernigan Dr Se, Atlanta, GA 30315-7557 | 2020-02-01 |
| 1962049577 | Yoichiro Shimada | Specialist/Technologist | 4222 Rickenbacker Dr Ne Unit 14, Atlanta, GA 30342-3768 | 2019-12-02 |
| 1245882398 | Jaycie Gail Emery | Specialist/Technologist | 5385 Peachtree Dunwoody Rd Apt 803, Atlanta, GA 30342-2167 | 2019-07-09 |
| 1053973313 | Robert Chavis | Specialist/Technologist | 150 Bobby Dodd Way Edge Building Athletic Training Room, Atlanta, GA 30332-0001 | 2019-07-07 |
| 1649832403 | Sarah Twomey | Specialist/Technologist | 1100 Circle 75 Pkwy Se Ste 1400, Atlanta, GA 30339-3067 | 2019-07-02 |
| 1881159028 | Brandon Norris Spires | Specialist/Technologist | 6000 S Terminal Pkwy, Atlanta, GA 30344 | 2019-02-01 |
| 1083181341 | Erin Cole | Specialist/Technologist | Lakewood Ave Se, Atlanta, GA 30315 | 2018-10-25 |
| Find all providers in ATLANTA | ||||
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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.