COLLIN BLAKE FREDERICK (NPI# 1770050536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770050536 |
| Entity Type | Individual |
| Full Name | COLLIN BLAKE FREDERICK |
| Credential | LAT, ATC |
| Practice Address |
3005 Sardis Rd Gainesville GA 30506-2232 |
| Mailing Address |
76 Horserange Vista Ct Cleveland GA 30528-2387 |
| Practice Telephone | 9122947908 |
| Mailing Telephone | 9122947908 |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2018-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT003432 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3005 SARDIS RD |
| City | GAINESVILLE |
| State | GA |
| Zip Code | 30506-2232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598325599 | Ride With Us Medical Transport LLC | Non-emergency Medical Transport (VAN) | 3877 C. Rogers Rd, Gainesville, GA 30506 | 2019-06-20 |
| 1437678950 | Thomas William Stewart Jr. | Pathology | 3138 Marthasville Court, Gainesville, GA 30506 | 2017-09-15 |
| 1629353461 | Finding Faith Inc | Physical Therapist | 7985 Knight Road, Suite B, Gainesville, GA 30506 | 2011-10-12 |
| 1992961296 | Georgia Cvs Pharmacy L.L.C. | Durable Medical Equipment & Medical Supplies | 3709 Thompson Bridge Rd., Gainesville, GA 30506 | 2008-08-06 |
| 1477754067 | Black's Pediatric Therapy, Inc. | Occupational Therapist | 4502 Summer Gate Ct., Gainesville, GA 30506 | 2007-05-30 |
| 1962535377 | Kim Kerrick | Physical Therapist | Lanier Village Estates, Misty Morning Way, Gainesville, GA 30506 | 2007-03-14 |
| 1942339098 | Lorie Miller Stevens | Dentist | 5129 Cleveland Hwy, Gainesville, GA 30506 | 2007-03-05 |
| 1972544963 | Christie L Woodruff | Nurse Practitioner | 4371 Clarks Bridge Road, Gainesville, GA 30506 | 2006-06-09 |
| 1336113919 | Alison K Zavodny | Internal Medicine | 4875 Perry Rd, Gainesville, GA 30506 | 2006-02-13 |
| 1497739429 | Anga-lee Morgan Tipton | Nurse Practitioner | 4000 Village View Drive, Gainesville, GA 30506 | 2005-12-02 |
| Find all providers in zip 30506 | ||||
| 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 |
|---|---|---|---|---|
| 1124669841 | Kara Honea | Specialist/Technologist | 3834 Walnut Grove Way, Gainesville, GA 30506-7303 | 2019-10-03 |
| 1073163341 | Constance Andrews | Specialist/Technologist | 9435 Ne 77th Ct, Gainesville, FL 32609-1327 | 2019-09-18 |
| 1043860547 | Jonathan Edward Palomar | Specialist/Technologist | Lemerand Drive, Gainesville, FL 32611-0001 | 2019-09-17 |
| 1598310724 | Michael Garrett Mayhugh | Specialist/Technologist | 14535 John Marshall Hwy Ste 104, Gainesville, VA 20155-4024 | 2019-08-05 |
| 1598320160 | Erika Lopez | Specialist/Technologist | 5245 Hewell Rd, Gainesville, GA 30507-7734 | 2019-05-08 |
| 1740745272 | Kayla Dooley | Specialist/Technologist | 114 Washington St Se, Gainesville, GA 30501-3671 | 2019-02-08 |
| 1417421413 | Marissa Evonne Lucas | Specialist/Technologist | 4400 Sw 20th Ave Apt 5201, Gainesville, FL 32607-3902 | 2019-01-14 |
| 1558844142 | Kennedy Crocker | Specialist/Technologist | 4570 Montclair Cir, Gainesville, GA 30506-5131 | 2018-09-11 |
| 1164909180 | Robert James Creech | Specialist/Technologist | 905 E Highway 82 Ste 130, Gainesville, TX 76240-2269 | 2018-07-23 |
| 1417434564 | Emma Christine Wagner | Specialist/Technologist | 4400 Sw 20th Ave Apt 3203, Gainesville, FL 32607-3902 | 2018-07-22 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 30506 |
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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.