JORDAN RAE HARRELL (NPI# 1245795715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245795715 |
| Entity Type | Individual |
| Full Name | JORDAN RAE HARRELL |
| Practice Address |
1135 Barclay Cir Se Apt 331b Marietta GA 30060-2901 |
| Practice Telephone | 9194388840 |
| Mailing Telephone | 9194388840 |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2019-02-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1135 BARCLAY CIR SE APT 331B |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-2901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| 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. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477164341 | Mariam Yahaya | Student in an Organized Health Care Education/Training Program | 2655 Ravenoaks Pl, Marietta, GA 30062-5631 | 2020-08-13 |
| 1649897372 | Kyungran Gibson | Student in an Organized Health Care Education/Training Program | 2662 Shadow Bluff Dr Ne, Marietta, GA 30062-2568 | 2020-06-29 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1740819572 | Rudiona Hoxhaj | Student in an Organized Health Care Education/Training Program | 677 Church St Ne Attn: Gme, Marietta, GA 30060-1101 | 2020-04-03 |
| 1912536921 | Rabia Khan | Student in an Organized Health Care Education/Training Program | 77 Church St Ne, Marietta, GA 30060-1907 | 2020-04-02 |
| 1699302737 | Ankit Mathur | Student in an Organized Health Care Education/Training Program | 846 Paces Farm Trl Sw, Marietta, GA 30064-7550 | 2020-03-26 |
| 1114566247 | Shelby Anne Saltsman | Student in an Organized Health Care Education/Training Program | 352 Church St Ne, Marietta, GA 30060-1318 | 2020-01-07 |
| 1518521871 | Taylor Nicole Weintraub | Student in an Organized Health Care Education/Training Program | 1134 Waterford Green Ln, Marietta, GA 30068-2931 | 2019-04-23 |
| 1235692146 | Dakotah Rose Forell | Student in an Organized Health Care Education/Training Program | 667 Church St Ne, Marietta, GA 30060-1101 | 2019-04-08 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| Find all providers in MARIETTA | ||||
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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.