VALDOSTA STATE UNIVERSITY (NPI# 1578117388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578117388 |
| Entity Type | Organization |
| Organization Name | VALDOSTA STATE UNIVERSITY |
| Practice Address |
2525 N Patterson St Valdosta GA 31602-1735 |
| Mailing Address |
1500 N Patterson St Valdosta GA 31698-0100 |
| Practice Telephone | 2292532890 |
| Mailing Telephone | 2292452890 |
| Mailing Fax Number | 2292595129 |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2019-07-30 |
| Authorized Official Name | MR. PAUL HIGGS (DIRECTOR, ATHLETIC TRAINING CLINIC) |
| Authorized Official Telephone | 2292532890 |
| Authorized Official Credential | LAT, ATC |
| Is Organization Subpart | Y |
| Parent Organization Name | VALDOSTA STATE UNIVERSITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| Center For Exercise Medicine and Rehabilitation | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083132484 | Valdosta State University | Pharmacy | 200 Georgia Ave, Valdosta, GA 31698-3843 | 2017-09-06 |
| 1962787804 | Valdosta State University | Clinic/Center | 1500 N Patterson St, Valdosta, GA 31698-0100 | 2011-10-11 |
| Street Address |
2525 N PATTERSON ST |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-1735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912979543 | Paul P Higgs | Specialist/Technologist | 2525 N Patterson St, Valdosta, GA 31602-1735 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| 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 |
|---|---|---|---|---|
| 1508484718 | Mckenna Kristine Bachmann | Specialist/Technologist | Moody Air Force Base, Valdosta, GA 31605 | 2020-07-14 |
| 1851939797 | Chelsea Carter | Specialist/Technologist | 1300 Melody Ln Apt D14, Valdosta, GA 31601-7592 | 2019-12-10 |
| 1912544081 | Derykah Yates | Specialist/Technologist | 4318 Brandonshire Ln, Valdosta, GA 31605-7010 | 2019-12-07 |
| 1902443534 | Nicholas Thomas Hamilton | Specialist/Technologist | 805 Harmon Dr Apt C2, Valdosta, GA 31601-3603 | 2019-12-02 |
| 1437700838 | Tristan Carlos Garcia | Specialist/Technologist | 605 West Mary Street, Valdosta, GA 31601 | 2019-09-26 |
| 1780147421 | Claire Nicole Siceloff | Specialist/Technologist | 2092 S Sherwood Dr Apt 121, Valdosta, GA 31602-2249 | 2019-04-10 |
| 1962968925 | Olivia Spuler | Specialist/Technologist | 1500 North Ashley St, Valdosta, GA 31698-8828 | 2019-02-14 |
| 1528540804 | Alexander Stephen Cosper | Specialist/Technologist | 816 Valerie Pl, Valdosta, GA 31605-6426 | 2018-09-03 |
| 1063911295 | Chelsea Tatiyana Mayo | Specialist/Technologist | 1601 Norman Dr Apt Jj8, Valdosta, GA 31601-3247 | 2018-02-02 |
| 1073025961 | Maci Dee Fox | Specialist/Technologist | 605 W Mary Street, Valdosta, GA 31698-0001 | 2017-10-31 |
| Find all providers in VALDOSTA | ||||
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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.