OCTAVIO ANDRES TOBAR (NPI# 1033632203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033632203 |
| Entity Type | Individual |
| Full Name | OCTAVIO ANDRES TOBAR |
| Practice Address |
1950 Barrett Lakes Blvd Nw Apt 1213 Kennesaw GA 30144 |
| Mailing Address |
1950 Barrett Lakes Blvd Nw Apt 1213 Kennesaw GA 30144-7535 |
| Practice Telephone | 8134470124 |
| Mailing Telephone | 8134470124 |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2018-08-20 |
| NPI Deactivation Date | 12/05/2017 |
| NPI Reactivation Date | 2018-07-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT003335 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AL4196 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | SECRETARY OF STATE | AT003335 | 01 |
| FL | FLORIDA DEPARTMENT OF HEALTH | AL4196 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3300 W Camelback Rd, Phoenix, AZ 850173030 | 4804311822 |
| Street Address |
1950 BARRETT LAKES BLVD NW APT 1213 |
| City | KENNESAW |
| State | GA |
| Zip Code | 30144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205440054 | Physician Assistant Surgical Solutions | Surgery | 4290 Bells Ferry Road, Suite 134 - 1032, Kennesaw, GA 30144 | 2020-08-31 |
| 1487149340 | Creative Family Care Inc. | Social Worker | 1275 Shiloh Rd Nw Ste 3030, Kennesaw, GA 30144 | 2018-06-24 |
| 1851829220 | Sharon Mcmillan | Counselor | 1301 Shiloh Rd Nw Ste 1840, Kennesaw, GA 30144 | 2017-05-31 |
| 1073054680 | Metropolitan Health Care Plus Inc | Home Health | 445 Laurian Way, Kennesaw, GA 30144 | 2017-03-15 |
| 1649627969 | Caresouth Hha Holdings of Gainesville, LLC | Hospice Care, Community Based | 1000 Cobb Place Blvd Nw Ste 310, Kennesaw, GA 30144 | 2016-05-17 |
| 1851745988 | Joseph Mulligan | Social Worker | 1301 Shiloh Rd., Ste. 849, Kennesaw, GA 30144 | 2016-04-14 |
| 1629438601 | Youfit Health Clubs | Clinic/Center | 3895 Cherokee St Suite 100, Kennesaw, GA 30144 | 2016-03-03 |
| 1598156317 | Jodie Evans | Specialist | 1925 Vaughn Rd, Ste 200, Kennesaw, GA 30144 | 2015-02-16 |
| 1912302134 | Sleepmed Therapies, Inc. | Durable Medical Equipment & Medical Supplies | 1000 Cobb Place Blvd Nw Ste 510, Kennesaw, GA 30144 | 2014-10-30 |
| 1811390594 | Lisa Karla Parker | Counselor | 1055 Shiloh Rd Nw, Ste. 311, Kennesaw, GA 30144 | 2014-10-08 |
| Find all providers in zip 30144 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427516780 | Jake Anthony Tuchmann | Specialist/Technologist | 3892 Greensward Vw Nw, Kennesaw, GA 30144-5780 | 2019-03-06 |
| 1598248403 | Catherine Birchfield | Specialist/Technologist | 2404 Caylor Hill Pointe Nw, Kennesaw, GA 30152-5804 | 2018-09-07 |
| 1164904322 | Diana Lynn Schulze | Specialist/Technologist | 2110 Jockey Hollow Dr Nw, Kennesaw, GA 30152-3168 | 2018-09-04 |
| 1528563053 | Marilyn Corinna Daye | Specialist/Technologist | 3220 Busbee Dr Nw, Kennesaw, GA 30144-3042 | 2018-03-27 |
| 1982105797 | Amy Foote | Specialist/Technologist | 3355 George Busbee Pkwy Nw Apt 1117, Kennesaw, GA 30144-6854 | 2018-02-27 |
| 1730540485 | Steven Keus | Specialist/Technologist | 1898 Kennesaw Due West Rd Nw, Kennesaw, GA 30152-4221 | 2016-03-09 |
| 1124400676 | Danielle Alice Ulekowski | Specialist/Technologist | 3281 Owens Meadow Ln Nw, Kennesaw, GA 30152-2585 | 2015-06-22 |
| 1568679850 | Angela M. Guggino | Specialist/Technologist | 3400 Old 41 Hwy Nw, Kennesaw, GA 30144-1072 | 2007-05-17 |
| 1003941725 | Adam Reed Freeman | Specialist/Technologist | 4500 Due West Rd Nw, Kennesaw, GA 30152-3855 | 2007-02-22 |
| 1396774808 | Karen Elizabeth Pfeifer | Specialist/Technologist | 3264 Enclave Ct Nw, Kennesaw, GA 30152-6414 | 2006-06-30 |
| Find all providers in KENNESAW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.