STACEY JOHN (NPI# 1144634601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144634601 |
| Entity Type | Individual |
| Full Name | STACEY JOHN |
| Credential | ATC, OTC |
| Practice Address |
3580 Arcade St Vadnais Heights MN 55127-7135 |
| Mailing Address |
1285 Nininger Rd Hastings MN 55033-1086 |
| Practice Telephone | 6519685375 |
| Practice Fax Number | 6519685907 |
| Mailing Telephone | 6519685413 |
| Mailing Fax Number | 6514372988 |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2020-01-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2280 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
18-2775 | MN | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
3580 ARCADE ST |
| City | VADNAIS HEIGHTS |
| State | MN |
| Zip Code | 55127-7135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972573566 | Kirk Leslie Scofield | Family Medicine | 3580 Arcade St, Vadnais Heights, MN 55127-7135 | 2006-01-25 |
| 1679069751 | Caitlin Dewitt | Physical Therapist | 3580 Arcade St, Vadnais Heights, MN 55127-7135 | 2018-07-02 |
| 1760986624 | Diandra Shakira Williams | Physician Assistant | 3580 Arcade St, Vadnais Heights, MN 55127 | 2018-03-23 |
| 1912420704 | William R Turnquist | Specialist/Technologist, Other | 3580 Arcade St, Vadnais Heights, MN 55127-7135 | 2017-07-24 |
| 1174045884 | Trista Lee Norris | Physical Therapist | 3580 Arcade St, Vadnais Heights, MN 55127-7135 | 2017-07-13 |
| 1255860268 | Jessie Lauren Marolt | Physician Assistant | 3580 Arcade St, Vadnais Heights, MN 55127-7135 | 2017-06-05 |
| 1710410246 | Samuel Rauchwarter | Physical Therapist | 3580 Arcade St, Vadnais Heights, MN 55127-7135 | 2017-04-11 |
| 1457701286 | Lori A Fredericks | Physical Therapist | 3580 Arcade St, Vadnais Heights, MN 55127-7135 | 2016-06-13 |
| 1730536665 | Rachel A Hedden | Physical Therapist | 3580 Arcade St, Vadnais Heights, MN 55127-7135 | 2016-05-20 |
| 1144696980 | Rachel M Silbert | Physician Assistant | 3580 Arcade St, Vadnais Heights, MN 55127-7135 | 2015-08-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514058 | Taylor Nessa Draves | Behavior Technician | 1011 Meadowlamds Dr, White Bear Lake, MN 55127 | 2020-10-02 |
| 1578104196 | Patricia Lynn Bina | Technician | 3677 Centerville Rd, Vadnais Heights, MN 55127 | 2019-10-04 |
| 1023538469 | Dignicare Senior Management of Vadnais | Assisted Living Facility | 580 Liberty Way, Vadnais Heights, MN 55127 | 2017-06-27 |
| 1548610207 | Golden Elderly Care Suites LLC | Assisted Living Facility | 4624 Stoddart Circle, White Bear Lake, MN 55127 | 2016-06-14 |
| 1811018203 | Adam F Curtis | Dentist | 925 East County Road E, Suite 185, Vadnais Heights, MN 55127 | 2007-04-03 |
| 1134215700 | Phoenix Residence, Inc. | Intermediate Care Facility, Mentally Retarded | 785 E County Road E, Vadnais Heights, NE 55127 | 2006-10-04 |
| 1861404790 | Gerald James Pease | Optometrist | 850 East Co Rd E, Walmart Vision Center, Vadnais Heights, MN 55127 | 2006-08-12 |
| 1235629395 | Suite Living Senior Management | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55127 | 2018-05-15 |
| 1811370729 | Sonya L Knudson | Psychologist | 4444 Centerville Rd Ste 235, White Bear Lake, MN 55127 | 2015-07-09 |
| 1801275672 | Anne M Mcdonald | Social Worker | 4444 Centerville Road, Suite 235, White Bear Lake, MN 55127 | 2015-05-26 |
| Find all providers in zip 55127 | ||||
| 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 |
|---|---|---|---|---|
| 1861092165 | Jamie Lynn Erickson | Specialist/Technologist | 43628 374th Ln, Aitkin, MN 56431-4027 | 2020-10-27 |
| 1760082044 | Craig Daniel Merten | Specialist/Technologist | 5045 Division Ave # 5575, White Bear Lake, MN 55110-2663 | 2020-10-27 |
| 1154928927 | Heidi Frey | Specialist/Technologist | 4554 Lake Park Ct, Eagan, MN 55122-2515 | 2020-10-05 |
| 1851906887 | Teddy Ray Gildersleeve | Specialist/Technologist | 37320 Oriole Ave, Lindstrom, MN 55045-9109 | 2020-09-15 |
| 1851906697 | Tadd William Berg | Specialist/Technologist | 2415 W 9th St, Duluth, MN 55806-1150 | 2020-09-09 |
| 1952916793 | Megan Marie Hautajarvi | Specialist/Technologist | 2536 Peace Dr, Duluth, MN 55811-2971 | 2020-09-09 |
| 1871108795 | Bryce Mershon Beamish | Specialist/Technologist | 3501 Lowell St, Wayzata, MN 55391-3411 | 2020-09-09 |
| 1043825961 | Kevin Eskuri | Specialist/Technologist | 8090 172nd St W, Lakeville, MN 55044-6206 | 2020-09-09 |
| 1952916876 | Elizabeth Marie Altendorf | Specialist/Technologist | 1621 397th Ave Ne, Stanchfield, MN 55080-3303 | 2020-09-09 |
| 1699380519 | Kourtney Jean Palmi | Specialist/Technologist | 4922 Howard Gnesen Rd, Duluth, MN 55803-2710 | 2020-09-09 |
| Find all providers with the same taxonomy | ||||
| City | VADNAIS HEIGHTS |
| Zip Code | 55127 |
Please comment or provide details below to improve the information on STACEY JOHN.
| 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.