Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JERRY SHADBOLT, ATC
ActiveMR. JERRY SHADBOLT, ATC is a Athletic Trainer healthcare provider located in SUMTER, South Carolina. NPI 1932192671 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · SUMTER, SC
Registration Details
- NPI Number
- 1932192671
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 29, 2005 (20.921162672211 yrs)
- Last Updated
- Jul 8, 2007
- License
-
191 (SC)
Practice Information
- Address
-
1215 ALICE DRSUMTER, SC, 291501905Browse SC providers · Browse ZIP 29150
- Phone
- 8037785223
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in SUMTER, SC
| Name | Credential | NPI |
|---|---|---|
| MR. GARY G NELSON | ATC, SCAT | 1144327396 |
| WILLIAM EDWARD DUVALL | MS ATC | 1295826345 |
| MS. SONJA FORD MCLENDON | ATC | 1639260458 |
| STACIE FLIPPIN | — | 1225487010 |
| SPENCER PATRICK GILL | LAT | 1487005658 |
| SHEA SKORUSA | ATC, SCAT | 1558816041 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.