MR. JEREMY BRETT TEBLUM (NPI# 1548492630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548492630 |
| Entity Type | Individual |
| Full Name | MR. JEREMY BRETT TEBLUM |
| Credential | MSED, ATC, LAT |
| Practice Address |
800 S Tucker Dr Tulsa OK 74104-9700 |
| Practice Telephone | 8137276373 |
| Mailing Telephone | 8137276373 |
| Enumeration Date | 2009-08-22 |
| Last Update Date | 2019-09-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT7004 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
800 S TUCKER DR |
| City | TULSA |
| State | OK |
| Zip Code | 74104-9700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972135788 | Erin Elizabeth Gage | Specialist/Technologist | 800 S Tucker Dr, Tulsa, OK 74104-9700 | 2020-02-10 |
| 1881226694 | Christa Montgomery | Specialist/Technologist | 800 S Tucker Dr, Tulsa, OK 74104-9700 | 2020-02-10 |
| 1518599463 | Gage Murphy | Specialist/Technologist | 800 S Tucker Dr, Tulsa, OK 74104-9700 | 2020-02-09 |
| 1801427216 | Jill Gunther | Specialist/Technologist | 800 S Tucker Dr, Tulsa, OK 74104-9700 | 2020-02-04 |
| 1649801077 | Katelyn Elizabeth Robinson | Student in an Organized Health Care Education/Training Program | 800 S Tucker Dr, Tulsa, OK 74104-9700 | 2020-02-04 |
| 1508348699 | Rachel Gray | Specialist/Technologist | 800 S Tucker Dr, Tulsa, OK 74104-9700 | 2018-09-05 |
| 1285123836 | Carlos Bautista Enrique | Specialist/Technologist | 800 S Tucker Dr, Tulsa, OK 74104-9700 | 2018-05-08 |
| 1871032094 | University of Tulsa Alexander Health Center | Pediatrics | 800 S Tucker Dr, Tulsa, OK 74104-9700 | 2017-02-21 |
| 1871048843 | Ben Anderson | Specialist/Technologist | 800 S Tucker Dr, Tulsa, OK 74104-9700 | 2016-08-19 |
| 1861947152 | Greg Gardner | Specialist/Technologist | 800 S Tucker Dr, Tulsa, OK 74104-9700 | 2016-08-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
| Find all providers in zip 74104 | ||||
| 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 |
|---|---|---|---|---|
| 1083227110 | Mercedes Phegley | Specialist/Technologist | 2815 E 5th St Apt 1936, Tulsa, OK 74104-3122 | 2020-08-28 |
| 1689285363 | Meredith Galloway | Specialist/Technologist | 2806 E 8th St Apt 3022, Tulsa, OK 74104-7402 | 2020-08-14 |
| 1427681766 | Brianna Lee Brooks | Specialist/Technologist | 3014 E 8th St Apt 4313, Tulsa, OK 74104-7436 | 2020-02-14 |
| 1083245948 | Hana Young Clancy | Specialist/Technologist | 2626 S Trenton Ave, Tulsa, OK 74114-2728 | 2020-01-30 |
| 1770043275 | Kacee Schroeder | Specialist/Technologist | 1219 S Sandusky Ave, Tulsa, OK 74112-5215 | 2019-03-21 |
| 1780140293 | Lauren Runquist | Specialist/Technologist | 121 North Ave, Tulsa, OH 74101 | 2019-02-20 |
| 1588150312 | Campbell Ward Ernst | Specialist/Technologist | 3901 S Granite Ave, Tulsa, OK 74135-5557 | 2018-07-04 |
| 1154862969 | Kaelynn Justyne Lemke | Specialist/Technologist | 11920 E Apache St, Tulsa, OK 74116-1309 | 2017-03-13 |
| 1730635640 | Portia Resnick | Specialist/Technologist | 5707 E 24th Pl, Tulsa, OK 74114 | 2016-08-31 |
| 1588021174 | Peter Semrad | Specialist/Technologist | 3330 N Mingo Rd, Tulsa, OK 74116-1211 | 2016-01-27 |
| Find all providers in TULSA | ||||
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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.