MR. JERRY SHADBOLT ATC - NPI 1932192671 - Specialist/Technologist in Sumter, SC

Q: What is Jerry Shadbolt's NPI number?

The NPI number for Jerry Shadbolt is 1932192671. It was assigned to this individual provider in the NPPES registry on August 29, 2005. The provider is also known as Mr. Jerry Shadbolt Atc.

Q: What is Jerry Shadbolt's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

Q: When was this NPI record last updated?

The NPPES record for Jerry Shadbolt was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

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About Mr. Jerry Shadbolt Atc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JERRY SHADBOLT ATC (NPI 1932192671) is an individual athletic trainer provider in Sumter, South Carolina, licensed in South Carolina (191) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1932192671

Entity TypeIndividualMale

Primary Taxonomy2255A2300X

Provider Legal NameMR. JERRY SHADBOLTCredential: ATC

Location Address1215 ALICE DRSumter, SC 29150-1905

Mailing Address3145 Tamarah WaySumter, SC 29154-9556 · (803) 778-5223

Phone(803) 778-5223

Sole ProprietorNo

Enumeration DateAugust 29, 2005

Last NPPES UpdateJuly 13, 2026

✔ NPI 1932192671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2255A2300X

License✔ Licensed in SC · 191

Definition

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.

1215 ALICE DR, Sumter, SC 29150

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Other Names 1

Professional Name (2)Mr. Jerry Shadbolt Atc

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JONATHAN MALONE PTA/ATC

Physical Therapy Assistant