KATRINA HALEY CARL (NPI# 1164883930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164883930 |
| Entity Type | Individual |
| Full Name | KATRINA HALEY CARL |
| Credential | ATC, LAT |
| Practice Address |
98 Poplar St Blackfoot ID 83221-1758 |
| Mailing Address |
2509 Eagle Dr Ammon ID 83406-4919 |
| Practice Telephone | 5306357005 |
| Mailing Telephone | 5306357005 |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2016-03-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT-555 | ID | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
98 POPLAR ST |
| City | BLACKFOOT |
| State | ID |
| Zip Code | 83221-1758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609871474 | Wade H Flowers Jr. | Pharmacist | 98 Poplar St, Blackfoot, ID 83221-1758 | 2005-06-16 |
| 1629685177 | Lucus Craig Webb Christoffersen | Registered Nurse | 98 Poplar St, Blackfoot, ID 83221-1799 | 2020-09-29 |
| 1770111924 | Kywnynn Madsen | Dietitian, Registered | 98 Poplar St, Blackfoot, ID 83221-1758 | 2020-03-31 |
| 1235795915 | Megan Lewis | Advanced Practice Midwife | 98 Poplar St, Blackfoot, ID 83221-1758 | 2019-05-17 |
| 1083177935 | Jason Lee Harmon | Student in an Organized Health Care Education/Training Program | 98 Poplar St, Blackfoot, ID 83221-1758 | 2019-04-08 |
| 1851870091 | Jennifer L Wistisen | Physician Assistant | 98 Poplar St, Blackfoot, ID 83221-1799 | 2018-08-08 |
| 1114405396 | Ryan Blair Killpack | Physician Assistant | 98 Poplar St, Blackfoot, ID 83221-1758 | 2018-07-31 |
| 1023504651 | Amanda Wray | Pharmacist | 98 Poplar St, Blackfoot, ID 83221-1758 | 2018-07-06 |
| 1699268276 | Zachary D Morrow | Nurse Anesthetist, Certified Registered | 98 Poplar St, Blackfoot, ID 83221-1758 | 2018-06-08 |
| 1184115107 | Megan Nicole Broyles | Pharmacist | 98 Poplar St, Blackfoot, ID 83221 | 2018-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932711165 | Samantha Paige Averett | Social Worker | 60 N Broadway, Blackfoot, ID 83221 | 2020-08-19 |
| 1730711656 | Sara Marie Letham | Family Medicine | 33 S Thompson Lane, Blackfoot, ID 83221 | 2020-02-08 |
| 1962994962 | Tyler Thomas Wood | Student in an Organized Health Care Education/Training Program | 98 Poplar Street, Blackfoot, Id 83221, Blackfoot, ID 83221 | 2018-06-05 |
| 1801336276 | Bmh, Inc. | Internal Medicine | 235 Poplar St, Blackfoot, ID 83221 | 2017-03-03 |
| 1497119804 | Susan Doran | Social Worker | 720 E. Alice, Blackfoot, ID 83221 | 2016-04-12 |
| 1427412121 | Josie Russell Adkins | Counselor | 720 East Alice, Blackfoot, ID 83221 | 2016-04-08 |
| 1740590314 | Ashley Nichole Thomas | Physician Assistant | 710 E. Alice Street, Blackfoot, ID 83221 | 2010-10-18 |
| 1528373313 | Stephanie Lynn Henderson | Dietitian, Registered | 1555 Vernon Ave, Blackfoot, ID 83221 | 2010-08-17 |
| 1184850141 | Joy H. Taylor | Nurse Practitioner | 1441 Parkway Drive, Blackfoot, ID 83221 | 2009-06-04 |
| 1427232925 | Nathan E. Sneddon | Anesthesiology | 98 Poplar St Fl 3, Blackfoot, ID 83221 | 2007-12-20 |
| Find all providers in zip 83221 | ||||
| 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] |
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|---|---|---|---|---|
| 1063030237 | Brandon Garfield | Specialist/Technologist | 3287 W Twin Rd, Moscow, ID 83843-8130 | 2020-07-14 |
| 1831717040 | Anna Richter | Specialist/Technologist | 1946 W Janet Ct, Eagle, ID 83616-3757 | 2020-07-14 |
| 1811515067 | Lexis Fouts | Specialist/Technologist | 617 W Taylor Ave # A, Moscow, ID 83843-2411 | 2020-07-13 |
| 1073131629 | Shaelynn Meek | Specialist/Technologist | 1350 E Warm Springs Ave, Post Falls, ID 83854-9693 | 2020-07-09 |
| 1063039204 | Jadelyn Taylor Eisele | Specialist/Technologist | 707 Railroad St Apt 4, Moscow, ID 83843-2381 | 2020-07-04 |
| 1366069593 | Tyler Hempfling Volkmann | Specialist/Technologist | 924 Indian Hills Dr, Moscow, ID 83843-5096 | 2020-07-03 |
| 1174149389 | Santiago A Segura Barron | Specialist/Technologist | Holt Arena 550 Memorial Drive Building 50, Pocatello, ID 83209-0001 | 2020-06-23 |
| 1942824545 | Maya S Gough | Specialist/Technologist | 10284 W Virginia City St, Star, ID 83669-5619 | 2020-05-31 |
| 1013531680 | Dalton Tanner Pitts | Specialist/Technologist | 1433 W A St, Moscow, ID 83843-3274 | 2020-05-29 |
| 1083238646 | Shyla Marie Flavel | Specialist/Technologist | 1022 W Recess Way, Kuna, ID 83634-2459 | 2020-05-29 |
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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.