Jeremy Fouts, EDS, MS, ATC
Individual provider Active NPI Athletic Trainer · Demorest, GA
NPI 1497315238 · NPPES record last updated Jun 14, 2019
Key facts
- NPI
- 1497315238
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- AT002587 (GA)
- Practice address
- 1021 Central Ave
Demorest, GA 30535-5252 - Phone
- (706) 776-0116
- Fax
- (706) 778-0701
- NPI assigned
- Jun 14, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT002587 | GA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT002587 | GA | Yes |
Addresses
Primary practice location
1021 Central Ave
Demorest, GA 30535-5252
Mailing address
1021 Central Ave
Demorest, GA 30535-5252
Other providers in Demorest, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.