Active NPI
Jordan Baudo
- Athletic Trainer
- Medina, TN
National Provider Identifier
1184249419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2015
- Practice address
- 29 Garrett Dr
Medina, TN 38355-9639 - Phone
- (731) 783-0263
- Fax
- (731) 783-0511
- NPI assigned
- Jun 12, 2020
- Last updated
- Jun 12, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2015 | TN | Primary |
Addresses
Primary practice location
29 Garrett Dr
Medina, TN 38355-9639
Mailing address
1804 Highway 45 Byp Ste 604
Jackson, TN 38305-4403
Phone (731) 660-8781
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015 | TN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lift Therapy, Inc. | Past | Accepting new patients | |
| Jackson Madison County General Hospital | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba JMCGH Radiology Professional
- Diagnostic Radiology Physician
- Jackson, TN
- NPI 1891687208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591920000000",
"number": "1184249419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1804 HIGHWAY 45 BYP STE 604",
"city": "JACKSON",
"state": "TN",
"postal_code": "383054403",
"telephone_number": "731-660-8781",
"fax_number": "731-660-8739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 GARRETT DR",
"city": "MEDINA",
"state": "TN",
"postal_code": "383559639",
"telephone_number": "731-783-0263",
"fax_number": "731-783-0511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUDO",
"first_name": "JORDAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-12",
"last_updated": "2020-06-12",
"certification_date": "2020-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "2015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medina, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.