Jeremy Keith King, M.ED, LAT, ATC, ITAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT002001 Issued in GA

Practice address

360 Rebels Cir
Blue Ridge, GA 30513-8137

Phone

(706) 455-5134

Fax

(706) 632-6552

NPI assigned

Jan 4, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1164939849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 BLACKBERRY LN",
            "city": "MORGANTON",
            "state": "GA",
            "postal_code": "305603700",
            "telephone_number": "706-455-5134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 REBELS CIR",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305138137",
            "telephone_number": "706-455-5134",
            "fax_number": "706-632-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JEREMY",
        "middle_name": "KEITH",
        "credential": "M.ED, LAT, ATC, ITAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT002001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATION ATHLETIC TRAINERS' ASSOCIATION MEMBER NUMBER",
            "identifier": "10001136",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lee Jones, MD
• Susan K Kauffman, LMHC
• Kennestone Heart Physicians Group
• Kenney S. Atkins M.D.,P.C.
• Kimberly R Denton, MD, PC
• Kaylee Elizabeth Kinser
• Lindsey Daugherty Kirn, PHARMD
• Elaine Margaret Kuhnel, RBT
• Frank David Kuitems, MD, ABIM BOARD CERT.
• Lauren B Lancaster, OT, CHT

• Athletic Trainer in Blue Ridge, GA
• Providers in Blue Ridge, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.