Joshua Ridikas Parker

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT002879 Issued in GA

Practice address

168 Ebenezer Church Rd
Fayetteville, GA 30215-5201

Phone

(770) 639-7949

NPI assigned

Feb 3, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1083205801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 EBENEZER CHURCH RD",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302155201",
            "telephone_number": "770-639-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 EBENEZER CHURCH RD",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302155201",
            "telephone_number": "770-639-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "JOSHUA",
        "middle_name": "RIDIKAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT002879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diliana K Panova, M.D.
• Jake Parham, OTR/L
• Hana Park
• Kevin U Park, MD
• Minhye Park, NP
• Julie Hall Parker, P.T.A.
• Roberta Jean Parker, DPM
• Parkside Pediatric and Orthodontic Care Inc
• Kathryn Perez Parr, NP
• Clarence A Parrott, DDS

• Athletic Trainer in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.