COREY CAUDLE (NPI# 1679029177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679029177 |
| Entity Type | Individual |
| Full Name | COREY CAUDLE |
| Credential | ATC |
| Practice Address |
439 Channel Rd Ste 102 Clover SC 29710-6101 |
| Mailing Address |
5005 Tara Tea Dr Tega Cay SC 29708-9362 |
| Practice Telephone | 8037467800 |
| Mailing Telephone | (803) 487-4325 |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2000028823 | SC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1300 Wheat St, Columbia, SC 292080001 | 8034874325 |
| Street Address |
439 CHANNEL RD STE 102 |
| City | CLOVER |
| State | SC |
| Zip Code | 29710-6101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346728243 | Jessica Pampalone | Pharmacist | 175 Sc-274, Lake Wylie, SC 29710 | 2018-08-02 |
| 1932628344 | Andrew Thomas Sullivan | Student in an Organized Health Care Education/Training Program | 106 Mccall Street, Clover, SC 29710 | 2017-09-18 |
| 1619423449 | Dental Professionals of South Carolina, P.C. | Dentist | 209 Latitude Lane, Clover, SC 29710 | 2016-08-31 |
| 1932538816 | Tara Mehta | Psychologist | 48 Fairway Rdg, Clover, SC 29710 | 2013-11-01 |
| 1710238795 | Hong N Mitchell | Pharmacist | 158 Hwy. 274, Lake Wylie, SC 29710 | 2012-10-01 |
| 1790948602 | Barbara Ellen Anslow-myers | Speech-Language Pathologist | 530 Little Cove Lane, Lake Wylie, SC 29710 | 2008-07-10 |
| 1720200884 | Lake Wylie | Assisted Living Facility | 4877 Charlotte Highway, Lake Wylie, SC 29710 | 2007-05-02 |
| 1790804581 | Phillip Russell Sanford | Pharmacist | 3272 Wicklow Ln, Clover, SC 29710 | 2007-03-29 |
| 1124158472 | Thomas N Stall Sr. | Dentist | 1100 Village Harbor Dr., Lake Wylie, SC 29710 | 2007-03-06 |
| 1043369457 | John Frank Ruocco | Dentist | 140 Highway 274, Clover, SC 29710 | 2007-01-09 |
| Find all providers in zip 29710 | ||||
| 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 |
|---|---|---|---|---|
| 1740677970 | Micah Traw | Specialist/Technologist | 354 Maynard Grayson Rd, Clover, SC 29710-9491 | 2015-04-26 |
| 1437160470 | Matthew Lee Bressler | Specialist/Technologist | 1625 Highway 55 E, Clover, SC 29710-8551 | 2006-08-11 |
| 1093937401 | Michael J. Ballard | Specialist/Technologist | 1625 Highway 55 E, Clover, SC 29710-8551 | 2007-05-03 |
| 1639264971 | Kimberly Strickland Bressler | Specialist/Technologist | 1625 Highway 55 E, Clover, SC 29710-8551 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548869563 | Brandon Lundin | Specialist/Technologist | 259 Dorchester Manor Blvd, North Charleston, SC 29420-8107 | 2020-10-21 |
| 1578160123 | Emma Faith Cornell | Specialist/Technologist | 9345 Blue House Rd, Apt 9302, Ladson, SC 29456-4093 | 2020-10-07 |
| 1932706587 | Devynn Galloway | Specialist/Technologist | 111 Springview Ln Apt 623, Summerville, SC 29485-8773 | 2020-10-07 |
| 1750988309 | Kirstyn Owen | Specialist/Technologist | 9345 Blue House Rd Apt 9302, Ladson, SC 29456-4093 | 2020-10-07 |
| 1902418106 | Kelli Brianna Adams | Specialist/Technologist | 12 He Mccracken Cir, Bluffton, SC 29910-5866 | 2020-08-19 |
| 1770195208 | Chely Mckoy | Specialist/Technologist | 126 Tidwell Ln, Swansea, SC 29160-8348 | 2020-08-17 |
| 1922610500 | Alexis Lauren Elrod | Specialist/Technologist | 907 Wesleyan Dr, Central, SC 29630-9748 | 2020-08-17 |
| 1356969737 | Skylar Brynn Hudgens-wallace | Specialist/Technologist | 208 Amelia Oaks Way, Columbia, SC 29209-1753 | 2020-07-11 |
| 1295353936 | Kayla Faylyn Nicole Mckenzie | Specialist/Technologist | 1905 Southern Drive, Unit 1905a, Columbia, SC 29201 | 2020-07-09 |
| 1235757162 | Jordan-lee Elizabeth Dobbins | Specialist/Technologist | 1011 Catawba Cir, Columbia, SC 29201-5252 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
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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.