JUSTIN TRAYLOR (NPI# 1558887109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558887109 |
| Entity Type | Individual |
| Full Name | JUSTIN TRAYLOR |
| Credential | ATC |
| Practice Address |
1201 Old Highway 49 S Ste 2 Richland MS 39218-9617 |
| Practice Telephone | 7692338844 |
| Mailing Telephone | 7692338844 |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2017-08-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2000006889 | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BOARD OF CERTIFICATION | 2000006889 | 01 |
| Street Address |
1201 OLD HIGHWAY 49 S STE 2 |
| City | RICHLAND |
| State | MS |
| Zip Code | 39218-9617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295353290 | Ashley Smith Allen | Nurse Practitioner | Rankin Rural Medical Center, 129 Center Street Suite B, Richland, MS 39218 | 2020-07-07 |
| 1346590460 | Medical Systems Management LLC | Clinic/Center | 120 Sarborough St, Suite A, Richland, MS 39218 | 2012-09-17 |
| 1487801338 | Teresa Polk | Family Medicine | 811 Highway 49 South, Richland, MS 39218 | 2008-08-22 |
| 1629238530 | Recovercare, LLC | Durable Medical Equipment & Medical Supplies | 181 Davis Johnson Dr., Suite G, Richland, MS 39218 | 2008-06-13 |
| 1710177688 | Wiley Vision Care LLC | Optometrist | 200 Market Place Dr, Richland, MS 39218 | 2007-07-27 |
| 1821292731 | Tara Pharmacy | Pharmacy | 110 Metroplex Blvd, Suite H, Pearl, MS 39218 | 2007-06-13 |
| 1881797439 | Don A Gibson | Family Medicine | 811 Hwy 49 South, Richland, MS 39218 | 2006-09-07 |
| 1912914516 | Renalab Inc | Clinical Medical Laboratory | 197 Interstate Drive, Suite G, Richland, MS 39218 | 2006-08-03 |
| 1730667403 | Kasey Ray Hinton | Physical Therapist | 1201 Highway 49 S Ste 2, Richland, MS 39218 | 2018-08-03 |
| 1033693866 | Melodie Carol Brown | Nurse Practitioner | 1201 U.S. 49, Suite 1, Richland, MS 39218-3921 | 2018-09-18 |
| Find all providers in zip 39218 | ||||
| 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] |
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| 1962042325 | Noelle Maree Sernett | Specialist/Technologist | 3165 Willow Pointe Dr, Richland, WA 99354-2614 | 2020-01-13 |
| 1689237570 | Kallee Corbin | Specialist/Technologist | 1610 Venice Ln, Richland, WA 99352-7316 | 2019-04-17 |
| 1467961334 | Matthew Gray | Specialist/Technologist | 450 Hanford St, Richland, WA 99354-1622 | 2017-09-23 |
| 1548638919 | Amy Louise Mauro | Specialist/Technologist | 515 S Gull Lake Dr, Richland, MI 49083 | 2015-09-02 |
| 1245632199 | Matthew Pineo | Specialist/Technologist | 611 Cedar Ave, Richland, NJ 08350-2450 | 2014-09-23 |
| 1396011698 | Dawn May Morales | Specialist/Technologist | 1650 Larkspur Dr, Richland, WA 99352-7507 | 2012-03-30 |
| 1114044054 | Jill Dawn Harvill | Specialist/Technologist | 1979 Snyder St, Suite 150, Richland, WA 99354-5319 | 2007-03-24 |
| 1386771129 | Jody Stanton | Specialist/Technologist | 875 Swift Blvd, Richland, WA 99352-3592 | 2007-02-28 |
| 1760524631 | Jody Ann Treadway | Specialist/Technologist | 875 Swift Blvd, Richland, WA 99352-3592 | 2007-02-13 |
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| 1114532587 | David Vincent Hughes Jr. | Specialist/Technologist | 1 Priority Plaza, West Point, MS 39773 | 2020-09-13 |
| 1194333484 | Rebbecca Alister Ruckes | Specialist/Technologist | 741 Cr 503, Ripley, MS 38663-3866 | 2020-07-22 |
| 1164049102 | Catherine Meredith Pendergast | Specialist/Technologist | 36 Hill Dr., University, MS 38677 | 2020-06-25 |
| 1972137685 | Pamela Sue Ezell | Specialist/Technologist | 920 Cedar Lake Rd Ste C, Biloxi, MS 39532-2107 | 2020-03-03 |
| 1629600606 | Weldon Meng | Specialist/Technologist | 1084 Looxahoma Tyro Rd, Senatobia, MS 38668-6518 | 2020-02-07 |
| 1295374536 | Celia Shields | Specialist/Technologist | 1776 Brookhaven Dr, Southaven, MS 38671-3554 | 2020-01-03 |
| 1396384947 | Natasha Lea Hayes | Specialist/Technologist | 254 Springhill Rd, Laurel, MS 39443-7874 | 2019-12-30 |
| 1184263048 | Keizia Davidson | Specialist/Technologist | 153 Ripon Ct, Ridgeland, MS 39157-1265 | 2019-12-24 |
| 1730726530 | Stephen Thompson | Specialist/Technologist | 2816 Jim St, Tupelo, MS 38801-6763 | 2019-11-30 |
| 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.