Jared M Luke, MED, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT001443 Issued in GA

Practice address

256 Raleigh Way
Villa Rica, GA 30180-7020

Phone

(678) 787-9291

NPI assigned

Nov 12, 2007

Last updated

Jun 5, 2014By the provider in NPPES

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

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1841470473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 RALEIGH WAY",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301807020",
            "telephone_number": "678-787-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 RALEIGH WAY",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301807020",
            "telephone_number": "678-787-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKE",
        "first_name": "JARED",
        "middle_name": "M",
        "credential": "MED, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-12",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT001443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Villa Rica, GA
• Providers in Villa Rica, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.