STEPHEN WILLIAM JACON (NPI# 1356823363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356823363 |
| Entity Type | Individual |
| Full Name | STEPHEN WILLIAM JACON |
| Practice Address |
29 Muirfield Court Newnan GA 30265 |
| Practice Telephone | 9375462305 |
| Mailing Telephone | 9375462305 |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2019-06-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
29 MUIRFIELD COURT |
| City | NEWNAN |
| State | GA |
| Zip Code | 30265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265041537 | Shiva Bazargan | Pharmacist | 3116 Sr 34 West, Newnan, GA 30265 | 2020-07-23 |
| 1992322549 | Doctorsbeyond Inc. | Clinic/Center | 277 Skyview Court, Newnan, GA 30265 | 2020-06-30 |
| 1225652936 | Jerrica Conyers | Nurse Practitioner | 1635 Highwat 34 East Suite C, Newnan, GA 30265 | 2020-05-29 |
| 1982234688 | Morgan Elizabeth Bross | Physician Assistant | 1825 Ga- 34, Newnan, GA 30265 | 2020-01-22 |
| 1013553379 | Hopebridge LLC | Behavior Technician | 2147 Newnan Crossing Boulevard East, Newnan, GA 30265 | 2019-11-21 |
| 1518528116 | Stepping Stones Psychiatric Care LLC | Nurse Practitioner | 3025 Sharpsburg Mccullum Rd, Building B Suite 103, Newnan, GA 30265 | 2019-06-25 |
| 1881176832 | Blueprint Psychiatry, LLC | Psychiatry & Neurology | 1601 Highway 34 E Ste A, Newnan, GA 30265 | 2018-09-05 |
| 1548790769 | Timothy Collins | Physical Therapist | 1755 Ga-34, Suite 1300, Rehab Department, Newnan, GA 30265 | 2017-06-20 |
| 1497289748 | Edible Health & Wellness,llc | Clinic/Center | 90f Glenda Trace Pmb 318, Newnan, GA 30265 | 2017-04-13 |
| 1760921456 | Pinnacle Ems LLC | Ambulance | 4046 Sharpsburg Mccollum Rd., Suite 202, Newnan, GA 30265 | 2017-02-15 |
| Find all providers in zip 30265 | ||||
| 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 |
|---|---|---|---|---|
| 1790951168 | Janece A Risty | Specialist/Technologist | 85 Brookstone Crst, Newnan, GA 30265-3852 | 2008-05-05 |
| 1134505910 | Jordan Elizabeth Fowler | Specialist/Technologist | 1755 Highway 34 E, Newnan, GA 30265-5631 | 2015-08-04 |
| 1275883951 | Timothy Heath Blackmon | Specialist/Technologist | 354 Newnan Crossing Byp, Suite 200, Newnan, GA 30265-2323 | 2012-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455959 | Mary Lee Richardson | Specialist/Technologist | 1591 Glenn Pl Sw, Mableton, GA 30126-1170 | 2020-10-25 |
| 1295332914 | Cayla Mckeon | Specialist/Technologist | 11 W 11th St Apt 17, Columbus, GA 31901-4239 | 2020-10-06 |
| 1205442472 | Si'ara Washington Farris | Specialist/Technologist | 564 Hillandale Park Dr, Lithonia, GA 30058-8833 | 2020-09-22 |
| 1033723150 | Grant Pheil | Specialist/Technologist | 3523 Old Penia Rd, Cordele, GA 31015-7714 | 2020-09-04 |
| 1376157933 | Jesus E Aviles | Specialist/Technologist | 755 Battery Ave Se, Atlanta, GA 30339-3017 | 2020-09-01 |
| 1588276943 | Jaden T Harris | Specialist/Technologist | 2205 Moncrieff St, Augusta, GA 30906-8905 | 2020-08-18 |
| 1891306437 | Tinasia Smalls | Specialist/Technologist | 100 Woodland Dr Apt 1416, Statesboro, GA 30458-6365 | 2020-08-16 |
| 1407467590 | Samantha Jean Libby | Specialist/Technologist | 2550 Akers Mill Rd Se Apt F14, Atlanta, GA 30339-3271 | 2020-08-12 |
| 1083224224 | John Christopher Hamil | Specialist/Technologist | 812 S Park St Ste 1, Carrollton, GA 30117-4412 | 2020-08-03 |
| 1780294926 | Andrew Alcantar | Specialist/Technologist | 7340 Fairmount Hwy Se, Calhoun, GA 30701-4023 | 2020-08-03 |
| Find all providers with the same taxonomy | ||||
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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.