GLENN EDGERTON (NPI# 1083149231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083149231 |
| Entity Type | Individual |
| Full Name | GLENN EDGERTON |
| Credential | EDD, LAT |
| Practice Address |
1705 N San Francisco St Flagstaff AZ 86001-1348 |
| Mailing Address |
Po Box 15094 Flagstaff AZ 86011-0543 |
| Practice Telephone | 9285236837 |
| Mailing Telephone | 9285236837 |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2017-04-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
1079 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1705 N SAN FRANCISCO ST |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-1348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205391885 | Katherine Louise Nelson | Specialist/Technologist | 1705 N San Francisco St, Flagstaff, AZ 86001-1348 | 2019-02-07 |
| 1205359114 | Brandon Johnson | Specialist/Technologist | 1705 N San Francisco St, Flagstaff, AZ 86001-1348 | 2017-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| 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 |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1225637317 | Alexsys Cameran Stroh | Specialist/Technologist | 1349 S Burlington St, Flagstaff, AZ 86001-2446 | 2020-10-20 |
| 1497316327 | Kaylee Romo | Specialist/Technologist | 2291 W Alaska Ave, Flagstaff, AZ 86001-8715 | 2019-06-21 |
| 1083179691 | Gabriel Gaudreau | Specialist/Technologist | 305 E Mcconnell Dr Apt 4305, Flagstaff, AZ 86001-6554 | 2019-02-07 |
| 1205391802 | Kento Anjima | Specialist/Technologist | 305 E Mcconnell Dr Apt 4305a, Flagstaff, AZ 86001-6554 | 2019-02-07 |
| 1730644329 | Gabrielle Cler | Specialist/Technologist | 997 E Pine Knoll Dr Apt 1432, Flagstaff, AZ 86001-3188 | 2019-02-07 |
| 1891250510 | Samantha Ann Carpenter | Specialist/Technologist | 2101 N San Francisco St, Flagstaff, AZ 86001-1388 | 2019-02-06 |
| 1770047540 | Amanda Guerrero | Specialist/Technologist | 700 S Blackbird Roost Apt 76, Flagstaff, AZ 86001-6247 | 2019-01-25 |
| 1497219331 | Nichole Michelle Reynolds | Specialist/Technologist | 2926 S Tex Ln, Flagstaff, AZ 86001-9173 | 2019-01-24 |
| 1790249712 | Sara Alaine Chatham | Specialist/Technologist | 212 S Beaver St Apt B, Flagstaff, AZ 86001-5654 | 2019-01-23 |
| Find all providers in FLAGSTAFF | ||||
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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.