MR. JESSE P AMBURN (NPI# 1992991947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992991947 |
| Entity Type | Individual |
| Full Name | MR. JESSE P AMBURN |
| Credential | LAT,ATC |
| Practice Address |
3414 Golden Rd Tyler TX 75701-8336 |
| Practice Telephone | 9039397500 |
| Practice Fax Number | 9035310179 |
| Mailing Telephone | 9039397500 |
| Mailing Fax Number | 9035310179 |
| Enumeration Date | 2007-09-23 |
| Last Update Date | 2007-09-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT2013 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3414 GOLDEN RD |
| City | TYLER |
| State | TX |
| Zip Code | 75701-8336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487640173 | James Robert Harris | Orthopaedic Surgery | 3414 Golden Rd, Tyler, TX 75701-8336 | 2005-09-27 |
| 1104433739 | Ortholonestar, Pllc | Orthopaedic Surgery | 3414 Golden Rd, Tyler, TX 75701-8336 | 2020-09-28 |
| 1912528498 | Brooke Nicole Mcdaniel | Occupational Therapy Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2020-05-06 |
| 1912526153 | Iana G Harris | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2020-04-08 |
| 1104450832 | Lindsey Michelle Markel | Nurse Practitioner | 3414 Golden Rd, Tyler, TX 75701-8336 | 2020-03-03 |
| 1568009058 | East Texas First Surgical Support Pllc | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2019-12-04 |
| 1770144701 | Olsv3 Pllc | Orthopaedic Surgery | 3414 Golden Rd, Tyler, TX 75701-8336 | 2019-06-20 |
| 1740840651 | Samantha Anderson Ray | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2019-06-13 |
| 1326540097 | Jennifer Marie Mckelva | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2018-03-08 |
| 1730601790 | Justin Alan Williams | Nurse Practitioner | 3414 Golden Rd, Tyler, TX 75701-8336 | 2017-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| 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 |
|---|---|---|---|---|
| 1588270953 | Aaron Gibson | Specialist/Technologist | 427 W Rieck Rd Apt 231, Tyler, TX 75703-3672 | 2020-09-21 |
| 1215545405 | Olivia I Eweni | Specialist/Technologist | 16722 Shadyridge Dr, Tyler, TX 75703-7841 | 2020-07-14 |
| 1740800549 | Amanda Arakawa | Specialist/Technologist | 411 E Se Loop 323, Tyler, TX 75701-9633 | 2020-04-21 |
| 1336771518 | Laurel Elizabeth Trail | Specialist/Technologist | 4920 Thistle Dr Apt 67, Tyler, TX 75703-2912 | 2020-02-06 |
| 1528608239 | Tyler Rediger | Specialist/Technologist | 2695 S Sw Loop 323, Tyler, TX 75701-0753 | 2020-01-10 |
| 1366088692 | Colin Mark Shillinglaw | Specialist/Technologist | 1319 Earl Campbell Pkwy, Tyler, TX 75701-9697 | 2019-11-21 |
| 1235641507 | Christopher Carlito Enriquez | Specialist/Technologist | 3202 Shenandoah Dr, Tyler, TX 75701-7449 | 2017-10-26 |
| 1821518168 | Taylor M Huffman | Specialist/Technologist | 915 E Grande Blvd Apt 1403, Tyler, TX 75703-3989 | 2017-06-27 |
| 1023548187 | Juan Fernando Melgoza Jr. | Specialist/Technologist | 13172 Tx-64, Tyler, TX 75707 | 2017-06-12 |
| 1215466370 | Laurie Nafe | Specialist/Technologist | 411 E Southeast Loop 323, Tyler, TX 75701-9633 | 2017-06-12 |
| Find all providers in TYLER | ||||
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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.