AMANDA JACKSON (NPI# 1770017949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770017949 |
| Entity Type | Individual |
| Full Name | AMANDA JACKSON |
| Credential | ATC |
| Practice Address |
1269 Barclay Cir Se Marietta GA 30060-2903 |
| Mailing Address |
102 Wethersfield Dr Cary NC 27513-4965 |
| Practice Telephone | 9193700423 |
| Mailing Telephone | 9193700423 |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2017-04-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
LAT-2819 | NC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT003082 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669008397 | Amanda Jackson | Pharmacist | 1418a W Main St Ste A, Lebanon, TN 37087-3114 | 2020-03-13 |
| 1730692765 | Amanda Lyn Jackson | Occupational Therapist | 2222 S Rockport Rd, Boonville, IN 47601-7926 | 2017-11-13 |
| 1982143467 | Amanda Jackson | Occupational Therapist | 5305 Reserve Dr Ne, Brookhaven, GA 30319-5924 | 2017-02-17 |
| 1528309473 | Amanda Nicole Jackson | Licensed Practical Nurse | 923 Cottage Ave, Miamisburg, OH 45342-1805 | 2013-03-01 |
| 1013254887 | Amanda Meister Jackson | Pharmacist | 10358 Riverside Dr Ste 140, Palm Beach Gardens, FL 33410-4203 | 2013-01-13 |
| 1285905240 | Amanda Jackson | Occupational Therapist | 1760 Turning Leaf Trl, Haughton, LA 71037-9531 | 2012-01-23 |
| 1245368661 | Amanda L Jackson | Physical Therapist | 17 Carlton Rd, Hutchinson, KS 67502-4423 | 2007-02-28 |
| 1861452112 | Amanda Elizabeth Jackson | Occupational Therapist | 121 Cox St, Benton, AR 72015-4611 | 2006-03-23 |
| 1437763638 | Amanda Jackson | Pharmacist | 7301 Theodore Dawes Rd, Theodore, AL 36582-4029 | 2020-09-04 |
| 1205460045 | Amanda Jackson | Registered Nurse | 940 W Mount Vernon St Ste 220, Nixa, MO 65714-9613 | 2020-03-02 |
| Street Address |
1269 BARCLAY CIR SE |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-2903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326178294 | Peter J Wilson | Chiropractor | 1269 Barclay Cir Se, Marietta, GA 30060-2903 | 2007-03-07 |
| 1720621022 | Dustin Le | Specialist/Technologist | 1269 Barclay Cir Se, Marietta, GA 30060-2903 | 2019-10-20 |
| 1477039618 | Kara Lyn Sapp Sontag | Specialist/Technologist | 1269 Barclay Cir Se, Marietta, GA 30060-2903 | 2018-07-11 |
| 1851834808 | Robert Jarrod Vanatta | Specialist/Technologist | 1269 Barclay Cir Se, Marietta, GA 30060-2903 | 2016-11-23 |
| 1851790018 | David Koentop | Chiropractor | 1269 Barclay Cir Se, Life University: Lussi, Marietta, GA 30060-2903 | 2014-08-13 |
| 1275803835 | Paula Rhodes | Chiropractor | 1269 Barclay Cir Se, Marietta, GA 30060-2903 | 2012-01-12 |
| 1902033343 | Life University | Clinic/Center | 1269 Barclay Cir Se, Marietta, GA 30060-2903 | 2009-06-12 |
| 1437325933 | Christopher G Markie | Specialist/Technologist | 1269 Barclay Cir Se, Marietta, GA 30060-2903 | 2008-05-05 |
| 1538375514 | Frank Keith Schwitz | Chiropractor | 1269 Barclay Cir Se, Marietta, GA 30060-2903 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| 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 |
|---|---|---|---|---|
| 1477172096 | Melissa Stratton | Specialist/Technologist | 865 Chestnut Lake Dr Ne, Marietta, GA 30068-4218 | 2020-04-14 |
| 1457985079 | Sarah Mason O'connor | Specialist/Technologist | 837 Thackston Dr, Marietta, GA 30068-4365 | 2020-02-24 |
| 1194366708 | Briana Lynn Houle | Specialist/Technologist | 600 Greene St, Marietta, OH 45750-3203 | 2019-10-04 |
| 1922649722 | Alexis Mariner | Specialist/Technologist | 3001 Hembree Rd Ne, Marietta, GA 30062-4205 | 2019-10-02 |
| 1952955890 | Sarah Preston Williams | Specialist/Technologist | 710 Burning Tree Dr Se, Marietta, GA 30067-4722 | 2019-07-29 |
| 1821652298 | Bethany Wood | Specialist/Technologist | 1266 Barclay Cir Se, Marietta, GA 30060-2904 | 2019-04-30 |
| 1548726722 | Stephanie Boso | Specialist/Technologist | 550 Silver Globe Rd, Marietta, OH 45750-6324 | 2019-02-13 |
| 1528523099 | Shireon Deque' Gray | Specialist/Technologist | 2398 June Springs Dr Sw, Marietta, GA 30008-8137 | 2019-02-08 |
| 1326503897 | Brandi Lawane Pugh | Specialist/Technologist | 730 Franklin Gtwy Se Apt G5, Marietta, GA 30067-2839 | 2019-02-08 |
| 1245795715 | Jordan Rae Harrell | Specialist/Technologist | 1135 Barclay Cir Se Apt 331b, Marietta, GA 30060-2901 | 2019-02-08 |
| Find all providers in MARIETTA | ||||
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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.