Active NPI
Jeremy Tisdale, ATC, EMT-IV
- Athletic Trainer
- Nashville, TN
National Provider Identifier
1912381245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1680
- Practice address
- 1900 Belmont Blvd
Nashville, TN 37212-3758 - Phone
- (615) 460-8041
- NPI assigned
- Jul 16, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | 30732 | TN | |
| Athletic Trainer | 2255A2300X | 1680 | TN | Primary |
Addresses
Primary practice location
1900 Belmont Blvd
Nashville, TN 37212-3758
Mailing address
1215 21St Ave S
Medical Center East South Tower Suite 3200
Nashville, TN 37232-0014
Phone (615) 460-8041
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 |
|---|---|---|---|
| 30732 | TN | MD | Basic Emergency Medical Technician |
| 1680 | TN | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437091200000",
"number": "1912381245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 21ST AVE S",
"address_2": "MEDICAL CENTER EAST SOUTH TOWER SUITE 3200",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372320014",
"telephone_number": "615-460-8041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 BELMONT BLVD",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372123758",
"telephone_number": "615-460-8041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TISDALE",
"first_name": "JEREMY",
"credential": "ATC, EMT-IV",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-16",
"last_updated": "2015-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "TN",
"license": "30732",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "1680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.