MARY PESICKA (NPI# 1043791072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043791072 |
| Entity Type | Individual |
| Full Name | MARY PESICKA |
| Credential | ATC |
| Practice Address |
900 N Benton Ave Springfield MO 65802-3712 |
| Mailing Address |
1222 S John Ave Springfield MO 65804-0631 |
| Practice Telephone | 2165096218 |
| Mailing Telephone | 2165096218 |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2018-08-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2018026629 | MO | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
900 N BENTON AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65802-3712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326485665 | Lester E Cox Medical Centers | Nurse Practitioner | 900 N Benton Ave, Springfield, MO 65802-3712 | 2013-05-28 |
| 1790209187 | Andrea Allison | Specialist/Technologist | 900 N Benton Ave, Springfield, MO 65802-3712 | 2017-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454549 | Andrea Strauch | Counselor | 2024 W Chestnut Expressway Way, Springfield, MO 65802 | 2020-10-12 |
| 1962968867 | Chad Michael Linck | Specialist/Technologist | 2125 N Glenstone Ave, Springfield, MO 65802 | 2019-02-15 |
| 1790254647 | Meds To Live By | Pharmacist | 1134 N. Scarlett Way, Springfield, MO 65802 | 2018-11-21 |
| 1568945103 | Ficom | Non-Pharmacy Dispensing Site | 1308 North Glenstone Avenue, Springfield, MO 65802 | 2018-09-10 |
| 1982194775 | Karla Caballero | Marriage & Family Therapist | 8627 Montant Fort Way, 145, Sprinfield, MO 65802 | 2018-05-16 |
| 1780191809 | Tiffany Chawntay Coryell | Pharmacist | 1134 North Scarlett Way, Springfield, MO 65802 | 2018-01-10 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1407389596 | Medical Mile Imaging | Radiology | 3905 E Windsmore Dr, Springfield, MO 65802 | 2017-04-06 |
| 1346619103 | Jill A Knight | Occupational Therapist | 1601 E. Pythian, Green Valley State School, Springfield, MO 65802 | 2015-09-22 |
| 1447653258 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3720 E Sunshine St, Springfield, MO 65802 | 2014-10-07 |
| Find all providers in zip 65802 | ||||
| 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 |
|---|---|---|---|---|
| 1467051516 | Kangjun Lee | Specialist/Technologist | 901 S. National Ave., Springfield, MO 65897 | 2020-10-20 |
| 1740806413 | Megan Herter | Specialist/Technologist | 1513 Old Ivy Dr, Springfield, IL 62711-8156 | 2020-06-18 |
| 1124649702 | Bridget Fenger | Specialist/Technologist | 521 W Central St, Springfield, MN 56087-1213 | 2020-05-05 |
| 1598302846 | Tamanna Kazi | Specialist/Technologist | 6746 Metropolitan Center Dr Apt 204, Springfield, VA 22150-4582 | 2019-12-05 |
| 1861035172 | Kory Matthew Kasper | Specialist/Technologist | 117 N Pittsburg Lndg, Springfield, IL 62711-8208 | 2019-10-21 |
| 1760037691 | Lauren Potter | Specialist/Technologist | 607 Highland Rd, Springfield, VT 05156-8844 | 2019-08-07 |
| 1033763271 | Ariana Nicole Hetland-purna | Specialist/Technologist | 1045 Grand St (art Annex Building), Springfield, MO 65897-0001 | 2019-07-25 |
| 1962968867 | Chad Michael Linck | Specialist/Technologist | 2125 N Glenstone Ave, Springfield, MO 65802 | 2019-02-15 |
| 1669938080 | Corey Michael Ratsch | Specialist/Technologist | 1116 E Cherry St Rm 300, Springfield, MO 65807-1517 | 2019-02-11 |
| 1164987640 | Emilee Pierce | Specialist/Technologist | 2015 W University St Apt E212, Springfield, MO 65807-7890 | 2019-02-08 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65802 |
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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.