STEPHANIE BLAKE (NPI# 1144710815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144710815 |
| Entity Type | Individual |
| Full Name | STEPHANIE BLAKE |
| Credential | ATC/LAT |
| Practice Address |
60 W Fulbright St Walnut Ridge AR 72476-9000 |
| Mailing Address |
211 Fairgrounds Rd Harrisburg AR 72432-1306 |
| Practice Telephone | 8702085631 |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2018-05-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT701 | AR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649365362 | Stephanie Kuulei Blake | Social Worker | 26 W Hidden Hollow Dr, Orem, UT 84058-7497 | 2006-10-04 |
| 1376109272 | Stephanie Blake | Behavior Technician | 1525 Ridgewood Dr, Midland, MI 48642-6425 | 2019-05-15 |
| 1841707403 | Stephanie S Blake | Social Worker | 7272 Wurzbach Rd Ste 706, San Antonio, TX 78240-4803 | 2018-01-04 |
| 1164811279 | Stephanie Kay Blake | Physical Therapist | 8537 Asheville Hwy, Suite 201, Knoxville, TN 37924-4124 | 2015-01-13 |
| 1366840910 | Stephanie Blake | Pharmacist | 77 Chicago Ave, Staten Island, NY 10305-3757 | 2014-12-15 |
| 1003124769 | Stephanie Danielle Blake | Physical Therapist | 621 W 21st St, Andover, KS 67002-8498 | 2010-09-15 |
| 1053585638 | Stephanie Mccallum Blake | Nurse Practitioner | Baptist Medical Center, 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2008-04-15 |
| Street Address |
60 W FULBRIGHT ST |
| City | WALNUT RIDGE |
| State | AR |
| Zip Code | 72476-9000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871113126 | Lauren Felts | Pharmacist | 1405 W Main Suite B, Walnut Ridge, AR 72476 | 2020-04-16 |
| 1033609995 | Misty Dawn Colvey | Specialist/Technologist | 60 W Fulbright Avenue, Walnut Ridge, AR 72476 | 2018-05-16 |
| 1427570803 | Heartline Home Care LLC | Home Health | 329 West Poplar, Walnut Ridge, AR 72476 | 2017-07-07 |
| 1093246035 | Allyson Claire Smith | Case Manager/Care Coordinator | 1425 W Main, Walnut Ridge, AR 72476 | 2017-03-22 |
| 1780134098 | H4l Ranch, Inc. | Community Based Residential Treatment Facility, Mental Illness | 853 Us 63, Walnut Ridge, AR 72476 | 2016-10-11 |
| 1386023943 | Meghon Lanae Mink | Physical Therapist | 200 South Memorial Drive, Walnut Ridge, AR 72476 | 2015-05-28 |
| 1013308436 | Meaghan Danielle Kingston | Nurse Practitioner | 1045 W Main St Ste C, Walnut Ridge, AR 72476 | 2015-02-06 |
| 1962789826 | Amber Fawn Adams | Family Medicine | 402 Sw Larkspur Dr, Walnut Ridge, AR 72476 | 2011-11-07 |
| 1528348760 | Pamela Wilcoxson | Case Manager/Care Coordinator | 1425 West Main, Walnut Ridge, AR 72476 | 2011-08-19 |
| 1184928764 | Lauara Beth Rhein | Case Manager/Care Coordinator | 1425 West Main Street, Walnut Ridge, AR 72476 | 2010-12-22 |
| Find all providers in zip 72476 | ||||
| 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 |
|---|---|---|---|---|
| 1033609995 | Misty Dawn Colvey | Specialist/Technologist | 60 W Fulbright Avenue, Walnut Ridge, AR 72476 | 2018-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356953533 | Sierra Paige Marsh | Specialist/Technologist | 909 S Booth Rd, Searcy, AR 72143-9354 | 2020-08-19 |
| 1912518119 | Kayla Johnson | Specialist/Technologist | 410 Ouachita St Rm 202, Arkadelphia, AR 71998-0001 | 2020-08-11 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1013538925 | Josh Dyre Lammers | Specialist/Technologist | 163h E Hwy 18, Blytheville, AR 72315-8937 | 2020-05-01 |
| 1083235998 | Lorenzo Soto | Specialist/Technologist | 444 Dogwood Cove, Marion, AR 72364 | 2020-05-01 |
| 1093336323 | Nick Lee Haywood | Specialist/Technologist | 1900 Mcnatt Dr Apt 16, Brookland, AR 72417-9024 | 2020-04-28 |
| 1780205195 | Tayler Estrada | Specialist/Technologist | 113 Nw Yukon Trail St, Bentonville, AR 72712-5013 | 2020-04-27 |
| 1619502531 | Angelina Marconi | Specialist/Technologist | 410 Charleston Cv, Marion, AR 72364-2673 | 2020-03-11 |
| 1508496191 | Savannah Deann Hart | Specialist/Technologist | 265 County Road 2168, Hartman, AR 72840-8809 | 2020-01-22 |
| 1144850967 | Victoria Lynn Rollins | Specialist/Technologist | 8 Christopher Dr, Sherwood, AR 72120-4010 | 2020-01-21 |
| Find all providers with the same taxonomy | ||||
| City | WALNUT RIDGE |
| Zip Code | 72476 |
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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.