Jordan Reid Johnson, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

3602 Issued in NC

Practice address

191 Main St
Banner Elk, NC 28604-9626

Phone

(828) 898-8892

NPI assigned

Oct 19, 2017

Last updated

Oct 19, 2017By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1174034938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 128",
            "city": "BANNER ELK",
            "state": "NC",
            "postal_code": "286040128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 MAIN ST",
            "city": "BANNER ELK",
            "state": "NC",
            "postal_code": "286049626",
            "telephone_number": "828-898-8892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JORDAN",
        "middle_name": "REID",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-19",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "3602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Beu Hill, M.D.
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• Carl Bradley Huff Jr., MS,LAT,ATC
• Tracy Jenkins, FNP-C
• Jonathan Bratter, DO Facog PA
• Robert Jones, RDCS, RVT
• David Paul Kimmel, MD
• Billy Joel King, D.PH
• Stephanie Knowles, LCSW

• Athletic Trainer in Banner Elk, NC
• Providers in Banner Elk, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.