Active NPI
Tristan Rodik
- Athletic Trainer
- Atlanta, GA
National Provider Identifier
1902298235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2014028857
- Practice address
- 26 Eagle Row NE FL 3
Atlanta, GA 30322-1512 - Phone
- (404) 727-6714
- NPI assigned
- Feb 24, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2014028857 | MO | Primary |
Addresses
Primary practice location
26 Eagle Row NE FL 3
Atlanta, GA 30322-1512
Mailing address
3950 Newman Rd
Joplin, MO 64801-1512
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | trodik@emory.edu | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2014028857 | MO | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578441600000",
"number": "1902298235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3950 NEWMAN RD",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648011512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 EAGLE ROW NE FL 3",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221512",
"telephone_number": "404-727-6714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODIK",
"first_name": "TRISTAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-02-24",
"last_updated": "2020-01-08",
"certification_date": "2020-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MO",
"license": "2014028857",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "trodik@emory.edu",
"affiliation": "N",
"endpointDescription": "Emory University E-mail",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "26 Eagle Row NE Fl 3",
"city": "Atlanta",
"state": "GA",
"country_code": "US",
"postal_code": "303221512",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.