Jeremy Harville, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT-0617 Issued in MS

Practice address

221 Warrior Dr
Senatobia, MS 38668-2726

Phone

(337) 794-9314

NPI assigned

Mar 18, 2024

Last updated

Mar 18, 2024By 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

State licenses

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1255190807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "493 COUNTRY CLUB DR",
            "city": "SENATOBIA",
            "state": "MS",
            "postal_code": "386686316",
            "telephone_number": "337-794-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 WARRIOR DR",
            "city": "SENATOBIA",
            "state": "MS",
            "postal_code": "386682726",
            "telephone_number": "337-794-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARVILLE",
        "first_name": "JEREMY",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MS",
            "license": "AT-0617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Senatobia, MS
• Providers in Senatobia, MS by specialty
• Athletic Trainer in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.