Cody James Jefferson, MBA, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0000002259 Issued in TN

Practice address

15 Mount Pelia Rd
Martin, TN 38237-3313

Phone

(731) 881-7679

NPI assigned

Apr 8, 2020

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 Business Administration

State licenses

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1437788601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 MOUNT PELIA RD APT 19",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382373399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MOUNT PELIA RD",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382373313",
            "telephone_number": "731-881-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "CODY",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "MBA, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "0000002259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Claire Hooper, APRN
• Anna K Hopla, MD
• Sarah Elizabeth Huffstetler, APRN
• Amelia R Hughes, CRNA
• Kristi Renae Jarrett, OTR
• Amanda Brooke Jenkins, FNP-C
• Brenn Mitchell Johnson, CRNA
• Emily Belote Johnson, COTA
• Rebecca N Johnson, CNMW
• Robert Jones Mark Jones

• Athletic Trainer in Martin, TN
• Providers in Martin, TN by specialty
• Athletic Trainer in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.

Verify at the official NPI Registry.