MR. JEREMY LANCE EDGERSON (NPI# 1396382024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396382024 |
| Entity Type | Individual |
| Full Name | MR. JEREMY LANCE EDGERSON |
| Credential | ATC, CCMA |
| Practice Address |
120 Ne Saint Lukes Blvd Ste 200 Lees Summit MO 64086-6011 |
| Mailing Address |
10812 Fremont Ave Kansas City MO 64134-2502 |
| Practice Telephone | 8162464302 |
| Mailing Telephone | 8165209965 |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2019-12-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2019005566 | MO | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
120 NE SAINT LUKES BLVD STE 200 |
| City | LEES SUMMIT |
| State | MO |
| Zip Code | 64086-6011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851352140 | Rockhill Orthopaedics Inc | Orthopaedic Surgery | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2006-03-28 |
| 1710500202 | Austin Christensen | Physician Assistant | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2020-05-19 |
| 1831730241 | Amity Brooke Sparkman | Physician Assistant | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2019-10-07 |
| 1790346468 | Hannah Calhoun | Specialist/Technologist | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2019-06-24 |
| 1164907622 | Michelle Webb | Nurse Practitioner | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086 | 2018-10-01 |
| 1205321569 | Rockhill Orthopaedic Specialists Inc | Orthopaedic Surgery | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2018-06-28 |
| 1104338367 | Chau Nguyen Herring | Nurse Practitioner | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2017-10-27 |
| 1366971301 | Tyler Timothy Triggs | Specialist/Technologist | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2017-06-04 |
| 1740728567 | Abbygail Hogan | Specialist/Technologist | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2017-02-01 |
| 1124565890 | Laura Ann George | Nurse Practitioner | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2017-01-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740821057 | David L Harrison | Pharmacist | 6 Nw Sycamore St Ste A, Lees Summit, MO 64086 | 2019-10-08 |
| 1770069403 | Foster Family Pharmacy | Pharmacy | 6 Nw Sycamore St., Suite A, Lee's Summit, MO 64086 | 2018-07-16 |
| 1255716221 | Summit Eye Center, LLC | Ophthalmology | 1621 Nw Blue Parkway, Lees Summit, MO 64086 | 2015-07-20 |
| 1679954085 | Day By Day Staff Relief, LLC | Hospice Care, Community Based | 943 Ne Columbus Street, Lees Summit, MO 64086 | 2015-06-11 |
| 1831505544 | Johnathan Almeida | Emergency Medicine | 100 Ne St Lukes Blvd, Emergency Department, Lees Summit, MO 64086 | 2014-07-02 |
| 1215358429 | Alex Sharifian Dds Summit Modern Dentistry PC | Dentist | 940 Nw Blue Parkway, Suite A, Lee's Summit, MO 64086 | 2013-12-16 |
| 1477807303 | Lauren M Lee | Nurse Practitioner | 1425 Nw Blue Parkway, Lee's Summit, MO 64086 | 2012-10-30 |
| 1396016507 | Retha Rene Rudloff | General Practice | 1728 N.e. Misty Lane, Lee's Summit, MO 64086 | 2012-01-19 |
| 1629351200 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 691 Nw Blue Pkwy, Lees Summit, MO 64086 | 2011-09-21 |
| 1497054308 | Jennifer Nelson | Physical Therapist | 301 Ne Tudor, Lee's Summit, MO 64086 | 2011-03-17 |
| Find all providers in zip 64086 | ||||
| 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 |
|---|---|---|---|---|
| 1477029080 | Susie Humphreys | Specialist/Technologist | 2600 Sw Ward Rd, Lees Summit, MO 64082-2107 | 2018-10-22 |
| 1316445646 | Allyson Gar-mei Ng | Specialist/Technologist | 2000 Se Blue Pkwy Ste 230, Lees Summit, MO 64063-1044 | 2018-02-01 |
| 1649639188 | Kristine Farrell | Specialist/Technologist | 1580 Ne Neawanna Dr, Lees Summit, MO 64086-5915 | 2016-02-11 |
| 1518351782 | Steven Taylor | Specialist/Technologist | 901 Ne Douglas St, Lees Summit, MO 64086-4505 | 2015-03-25 |
| 1063768257 | Elisa Marie Ray | Specialist/Technologist | 1254 Se Century Dr, Lees Summit, MO 64081-3286 | 2012-07-25 |
| 1578591004 | John R Donnell | Specialist/Technologist | 514 Se Granada St, Lees Summit, MO 64063-8500 | 2006-06-30 |
| 1790346468 | Hannah Calhoun | Specialist/Technologist | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2019-06-24 |
| 1366971301 | Tyler Timothy Triggs | Specialist/Technologist | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2017-06-04 |
| 1740728567 | Abbygail Hogan | Specialist/Technologist | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2017-02-01 |
| 1669825378 | Caleb Coale | Specialist/Technologist | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2016-07-18 |
| Find all providers in LEES SUMMIT | ||||
| City | LEES SUMMIT |
| Zip Code | 64086 |
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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.