Jeremy Tate Johnson, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT907 Issued in KY

Practice address

1637 Perryville Rd.
Boyle County High School
Danville, KY 40422

Phone

(859) 236-5047

Fax

(859) 236-6826

NPI assigned

May 14, 2015

Sex

Male

Sole proprietor

Yes

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cumberland Family Medical Center Inc

  dba Boyle County High Healthy Kids Clinic

  • Federally Qualified Health Center (FQHC)
  • Danville, KY
  • NPI 1023795242
  NPD (past)

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1801274550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1637 PERRYVILLE RD.",
            "address_2": "BOYLE COUNTY HIGH SCHOOL",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "40422",
            "telephone_number": "859-236-5047",
            "fax_number": "859-236-6826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1637 PERRYVILLE RD.",
            "address_2": "BOYLE COUNTY HIGH SCHOOL",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "40422",
            "telephone_number": "859-236-5047",
            "fax_number": "859-236-6826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEREMY",
        "middle_name": "TATE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KY",
            "license": "AT907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Duncan MD Consulting Service PLLC
• James Medical Equipment, LTD.
• Teodoro Jimenez, MD
• Erika B. Johnson, TCM
• Jeffrey T Johnson, DMD, MPH
• Laura Kathryn Jones, PHARM D.
• Kacie Kelso, AGACNP-BC
• Shana S Kench, LCSW
• Kenney Orthopedics of Danville LLC (Hanger Clinic II)
• Kentucky Counseling Associates, LLC

• Athletic Trainer in Danville, KY
• Providers in Danville, KY by specialty
• Athletic Trainer in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.