ANDREW MEDLOCK (NPI# 1861892697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861892697 |
| Entity Type | Individual |
| Full Name | ANDREW MEDLOCK |
| Credential | ATC |
| Practice Address |
1925 Cooper Landing Dr Se Smyrna GA 30080-6464 |
| Practice Telephone | 8034801275 |
| Mailing Telephone | 8034801275 |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2018-05-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407216260 | Andrew Tyler Medlock | Community Health Worker | 272 Medical Loop, Suite C, Roseburg, OR 97471 | 2016-03-07 |
| Street Address |
1925 COOPER LANDING DR SE |
| City | SMYRNA |
| State | GA |
| Zip Code | 30080-6464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205169 | Suny Varughese | Nurse Practitioner | Minute Clinic, 2994 Atlanta Rd, Se, Smyrna, GA 30080 | 2020-08-11 |
| 1891287645 | Provident Group - Creekside Properties LLC | Alzheimer Center (Dementia Center) | 4838 South Cobb Drive, Smyrna, GA 30080 | 2018-06-06 |
| 1710490743 | Alina Rim | Registered Nurse | 4532 Chelton Ct Se, Smyrna, GA 30080 | 2017-11-13 |
| 1932626488 | Richard Kyle Davis | Pharmacist | 2955 Atlanta Rd Se, Smyrna, GA 30080 | 2017-08-25 |
| 1982071163 | Amelia Rafaela Turrubiates-huacuja | Counselor | 1246-c Concord Rd, Suite 101, Smyrna, GA 30080 | 2015-08-24 |
| 1275919755 | Anne Waldner Rohling | Physical Therapist | 1155 Concord Rd Se Ste 210, Smyrna, GA 30080 | 2015-08-06 |
| 1790167856 | Kay Yetunde Johnson | Nurse Practitioner | 3001 Lusk Dr, Smyrna, GA 30080 | 2015-06-25 |
| 1689055436 | Anew You Couneling, LLC | Community/Behavioral Health | 3188 Atlanta Rd, Smyrna, GA 30080 | 2015-06-17 |
| 1457766370 | Trondi Jerry | Counselor | 3381 Atlanta Rd Se, Smyrna, GA 30080 | 2014-06-30 |
| 1093081903 | Ashish Kapila | Podiatrist | Wellstar Podiatry, 4441 Atlanta Rd Se Suite 215, Smyrna, GA 30080 | 2012-03-25 |
| Find all providers in zip 30080 | ||||
| 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 |
|---|---|---|---|---|
| 1346855400 | Aran A Porte | Specialist/Technologist | 204 Century Dr, Smyrna, DE 19977-4476 | 2020-09-14 |
| 1003436015 | Valerie Hope Todd | Specialist/Technologist | 255 Plantation Rd Sw, Smyrna, GA 30082-3046 | 2020-04-20 |
| 1982167789 | Marcus A Underwood | Specialist/Technologist | 123 Vinings Pkwy Se, Smyrna, GA 30080-3863 | 2019-04-09 |
| 1831653427 | Everett Morgan Boutwell | Specialist/Technologist | 100 Bulldog Dr, Smyrna, TN 37167-4445 | 2019-01-28 |
| 1417456674 | Kasey Sohmer | Specialist/Technologist | 2205 Lake Park Dr Se Apt N, Smyrna, GA 30080-8970 | 2018-02-02 |
| 1851838031 | Kiera Lane | Specialist/Technologist | 8521 Cumberland Glen Ln Se, Smyrna, GA 30080-4049 | 2017-01-25 |
| 1235505066 | Robert Carlos Avila Jr. | Specialist/Technologist | 5265 Ward St Se, Smyrna, GA 30080-1944 | 2015-08-16 |
| 1881083236 | Joshua Haley | Specialist/Technologist | 400 Chaney Rd Apt 1402, Smyrna, TN 37167 | 2015-01-22 |
| 1982092169 | Lauren Anne Brueck | Specialist/Technologist | 1218 Walton Ln Se, Smyrna, GA 30082-3873 | 2014-12-22 |
| 1922235431 | Aya Ieki | Specialist/Technologist | 421 Tibarron Pkwy Se, Smyrna, GA 30080-7282 | 2009-06-11 |
| Find all providers in SMYRNA | ||||
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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.