JACKSON KEITH MIZE ATC NPI 1881372829

NPI Information

  • NPI: 1881372829
  • Provider Name: JACKSON KEITH MIZE, ATC
  • Classification: Specialist/Technologist - 2255A2300X
  • Specialization: Athletic Trainer
  • Entity Type: Individual
  • Address: 590 COBB AVENUE MD #0201
    KENNESAW, GA
    ZIP 30144
  • Phone: (470) 578-2786

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NPI Details

Jackson Keith Mize, ATC is an athletic trainer specialist technologist in Kennesaw, GA. The provider is 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. Jackson Keith Mize, ATC NPI is 1881372829. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

590 COBB AVENUE MD #0201
KENNESAW, GA
ZIP 30144
Phone: (470) 578-2786

The enumeration date for this NPI number is 7/10/2023 and was last updated on 7/10/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12255A2300XSpecialist/TechnologistAthletic TrainerAT003505GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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