Active NPI
Jeremy Page
- Athletic Trainer
- Greenville, SC
National Provider Identifier
1366004038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT03240
- Practice address
- 3300 Poinsett Hwy
Greenville, SC 29613-2504 - Phone
- (864) 294-3553
- Fax
- (864) 294-3339
- NPI assigned
- Jul 2, 2019
- Last updated
- Nov 2, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | NU | ||
| Athletic Trainer | 2255A2300X | AT03240 | SC | Primary |
Addresses
Primary practice location
3300 Poinsett Hwy
Greenville, SC 29613-2504
Mailing address
4113 Enclave Paris Dr
Greenville, SC 29609-1351
Phone (770) 335-1191
Other practice location 1
615 McCallie Ave
Chattanooga, TN 37403-2504
Phone (423) 425-4111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000041105 | Other | BOC NUMBER |
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 |
|---|---|---|---|
| AT03240 | SC | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667347200000",
"number": "1366004038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4113 ENCLAVE PARIS DR",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296091351",
"telephone_number": "770-335-1191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 POINSETT HWY",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296132504",
"telephone_number": "864-294-3553",
"fax_number": "864-294-3339"
}
],
"practiceLocations": [
{
"address_1": "615 McCallie Ave",
"address_purpose": "LOCATION",
"city": "Chattanooga",
"state": "TN",
"postal_code": "374032504",
"country_code": "US",
"telephone_number": "423-425-4111",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAGE",
"first_name": "JEREMY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-02",
"last_updated": "2022-11-02",
"certification_date": "2022-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SC",
"license": "AT03240",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOC NUMBER",
"identifier": "2000041105",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
- Terry Lee Paden
- Brittany Padgett-Rayburn, BCBA
- Pagarr Enterprise LLC (Home Helpers and Direct Link)
- Cassidy Bryana Culbreth Page, OTR/L
- James B. Page, M.D.
- Kevan Wallace Page, PHARMD
- Natasha Cherelle Page, NURSE PRACTITIONER
- Ricky Calhoun Page, PARAMEDIC
- Margaret Lynn Pague
- Victoria Nicole Paige, RN, RNFA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.