Jeremy Brent Erdmann, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT387 Issued in KY

Practice address

405A N. Applied Sciences BLDG.
Murray State University, Dept. of Ahs
Murray, KY 42071-3306

Phone

(270) 809-4517

Fax

(270) 809-3815

NPI assigned

Feb 9, 2006

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1093788036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 GLOVER RD",
            "city": "KIRKSEY",
            "state": "KY",
            "postal_code": "420549033",
            "telephone_number": "270-705-4448",
            "fax_number": "270-809-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405A N. APPLIED SCIENCES BLDG.",
            "address_2": "MURRAY STATE UNIVERSITY, DEPT. OF AHS",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420713306",
            "telephone_number": "270-809-4517",
            "fax_number": "270-809-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERDMANN",
        "first_name": "JEREMY",
        "middle_name": "BRENT",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KY",
            "license": "AT387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.