JACOB MICKEY (NPI# 1124560115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124560115 |
| Entity Type | Individual |
| Full Name | JACOB MICKEY |
| Credential | MS, ATC, CSCS, CES |
| Practice Address |
376 Hale St Beverly MA 01915-2096 |
| Practice Telephone | 9782322309 |
| Mailing Telephone | 9782322309 |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2019-05-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
3174 | MA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
376 HALE ST |
| City | BEVERLY |
| State | MA |
| Zip Code | 01915-2096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336176924 | Katherine Moskal | Specialist/Technologist | 376 Hale St, Beverly, MA 01915-2096 | 2006-06-27 |
| 1184225401 | Margaret J Layo | Nurse Practitioner | 376 Hale St, Beverly, MA 01915-2096 | 2020-11-03 |
| 1669084265 | Kevin Kosiorek | Specialist/Technologist | 376 Hale St, Beverly, MA 01915-2096 | 2020-08-17 |
| 1831730373 | Sierra Miller | Specialist/Technologist | 376 Hale St, Beverly, MA 01915-2098 | 2019-10-07 |
| 1487200952 | Elizabeth Donahue | Specialist/Technologist | 376 Hale St, Beverly, MA 01915-2098 | 2019-08-12 |
| 1588128318 | Cynthia Fichera | Student in an Organized Health Care Education/Training Program | 376 Hale St, Beverly, MA 01915-2096 | 2019-01-25 |
| 1396253753 | Jennifer Concannon | Emergency Medicine | 376 Hale St, Beverly, MA 01915-2096 | 2018-01-18 |
| 1134634009 | Deborah Swanton | Specialist/Technologist | 376 Hale St, Beverly, MA 01915-2096 | 2017-12-13 |
| 1265896088 | Kelsey Steube | Specialist/Technologist | 376 Hale St, Beverly, MA 01915-2096 | 2016-04-07 |
| 1912361734 | Kevin Rooney | Specialist/Technologist | 376 Hale St, Beverly, MA 01915-2096 | 2016-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497377253 | Janice E. Schwartz | Psychologist | 100 Cummings Center, 232 C, Beverly, MA 01915 | 2020-05-14 |
| 1720625452 | Campos Dental Care PC | Dentist | 127 Dodge Street, Beverly, MA 01915 | 2019-12-02 |
| 1144781477 | Nutrimedy | Dietitian, Registered | 6 Oceanside Drive, Beverly, MA 01915 | 2019-03-28 |
| 1376001073 | Benjamin David Stebbings | Counselor | 199 Rosewood Dr. Suite 250, Beverly, MA 01915 | 2019-03-12 |
| 1376000455 | Patrick Matthew Noble | Occupational Therapist | Peer Projects - Therapy From The Heart, 100 Cummings Center Suite 350g, Beverly, MA 01915 | 2019-02-26 |
| 1174007900 | Nicole Morreo | Psychologist | 480 Rantoul St., 208, Beverly, MA 01915 | 2018-09-18 |
| 1891282299 | Jeanne Tomich | Psychologist | 110 Hart St., Beverly, MA 01915 | 2018-04-20 |
| 1518469089 | Kathleen L Golemon | Specialist | 100 Cummings Center Suite 158-d, Beverly, MA 01915 | 2018-03-01 |
| 1629582556 | Sarah Elizabeth Tsouvalas | Nurse Practitioner | 900 Cummings Center, Suite 111w, Lahey Health Primary Care, Beverly, Beverly, MA 01915 | 2017-11-30 |
| 1235657339 | Kathleen Ann Downey | Registered Nurse | Element Care, 166d Cummings Center, Beverly, MA 01915 | 2017-09-08 |
| Find all providers in zip 01915 | ||||
| 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 |
|---|---|---|---|---|
| 1942812128 | Samantha Norman Kheboian | Specialist/Technologist | 71 Lakeshore Ave, Beverly, MA 01915-1907 | 2020-08-19 |
| 1962042176 | Gina E Falzone | Specialist/Technologist | 100 Cummings Ctr Ste 136p100, Beverly, MA 01915-6115 | 2020-01-15 |
| 1053950709 | Colleen Jenkins | Specialist/Technologist | 35 Standley St, Beverly, MA 01915-2099 | 2019-12-29 |
| 1710536727 | Kelsey Hunter | Specialist/Technologist | 367 Hale St, Beverly, MA 01915-2029 | 2019-09-11 |
| 1215584693 | Scott Braid | Specialist/Technologist | 1 Pine Rd, Beverly, MA 01915-3729 | 2019-08-21 |
| 1194296640 | Elisabeth Hutchins | Specialist/Technologist | 77 Herrick St Ste 201, Beverly, MA 01915-2734 | 2018-12-10 |
| 1629594635 | Jennifer Rose Holman | Specialist/Technologist | 376 Hale St # 1077, Beverly, MA 01915-2096 | 2017-08-21 |
| 1659770006 | Moira Kathrine Kiley | Specialist/Technologist | 275 Cabot St Ste 6, Beverly, MA 01915-4526 | 2014-08-21 |
| 1871992891 | Jason L Edelstein | Specialist/Technologist | 23 Clifton Ave, Beverly, MA 01915-5625 | 2014-08-14 |
| 1356476725 | Anne M Flaherty | Specialist/Technologist | 1 Michael Rd, Beverly, MA 01915-1218 | 2007-02-23 |
| Find all providers in BEVERLY | ||||
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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.