Individual provider Active NPI

Jeremiah Lukers, LAT, CSCS

  • Athletic Trainer
  • Mount Airy, GA
National Provider Identifier
1669102448
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT002888 Issued in GA
Practice address
176 Rocky Shoals TRL
Mount Airy, GA 30563-3669
Phone
(814) 227-8601
NPI assigned
Jun 14, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT002888 GA Primary

Addresses

Primary practice location

176 Rocky Shoals TRL
Mount Airy, GA 30563-3669

Mailing address

176 Rocky Shoals TRL
Mount Airy, GA 30563-3669
Phone (814) 227-8601

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

LicenseStateTypeSpecialty
AT002888GAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1669102448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 ROCKY SHOALS TRL",
            "city": "MOUNT AIRY",
            "state": "GA",
            "postal_code": "305633669",
            "telephone_number": "814-227-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 ROCKY SHOALS TRL",
            "city": "MOUNT AIRY",
            "state": "GA",
            "postal_code": "305633669",
            "telephone_number": "814-227-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKERS",
        "first_name": "JEREMIAH",
        "credential": "LAT, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT002888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.

Verify at the official NPI Registry.