MRS. JACQUELINE ANN FUENTES (NPI# 1174068407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174068407 |
| Entity Type | Individual |
| Full Name | MRS. JACQUELINE ANN FUENTES |
| Credential | LAT,ATC |
| Practice Address |
120 Charlois Blvd Winston Salem NC 27103-1562 |
| Practice Telephone | 3367655664 |
| Practice Fax Number | 3367686713 |
| Mailing Telephone | 3367655664 |
| Mailing Fax Number | 3367686713 |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2016-12-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2075 | NC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356755268 | Jacqueline Pagnotta Fuentes | Social Worker | 1949 Castle Pines Dr, Raleigh, NC 27604-8466 | 2014-06-18 |
| 1639781958 | Jacqueline Fuentes | Registered Nurse | 1305 N Martin Ave, Tucson, AZ 85721-0001 | 2020-08-18 |
| 1669027447 | Jacqueline Fuentes | Student in an Organized Health Care Education/Training Program | 299 Hallock Ave, Port Jeff Sta, NY 11776-1217 | 2019-08-07 |
| Street Address |
120 CHARLOIS BLVD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-1562 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689634198 | Select Physical Therapy Holdings Inc | Clinic/Center | 120 Charlois Blvd, Winston Salem, NC 27103-1562 | 2006-03-27 |
| 1962910752 | Josh Benjamin Hogg | Physical Therapist | 120 Charlois Blvd, Winston Salem, NC 27103 | 2018-01-16 |
| 1801310347 | Lindsey N Ball | Specialist/Technologist | 120 Charlois Blvd, Winston Salem, NC 27103-1562 | 2017-07-26 |
| 1871037374 | Emily Lynn Mobley | Specialist/Technologist | 120 Charlois Blvd, Winston Salem, NC 27103-1562 | 2016-12-19 |
| 1144399809 | Heather Surrett-vestal | Physical Therapy Assistant | 120 Charlois Blvd, Winston Salem, NC 27103-1562 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| 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 |
|---|---|---|---|---|
| 1538654090 | Elizabeth Louise Watson | Specialist/Technologist | 257 Holmes Dr, Winston Salem, NC 27127-9150 | 2018-06-27 |
| 1215444690 | Margaret Elizabeth Vaughn | Specialist/Technologist | 5813 Luxbury Ct, Winston Salem, NC 27104-3374 | 2018-01-06 |
| 1750817524 | Stephen White | Specialist/Technologist | 5304 Quail Wood Dr Apt H, Winston Salem, NC 27104-5505 | 2017-05-11 |
| 1255718904 | John Kober | Specialist/Technologist | 1109 Stafford Place Cir Apt 302, Winston Salem, NC 27127-6884 | 2015-05-01 |
| 1629472667 | Stephen Andrews | Specialist/Technologist | 2054 Craig St, Winston Salem, NC 27103-2613 | 2014-10-20 |
| 1417361882 | Matthew Fortune | Specialist/Technologist | 5705 Shattalon Dr, Winston Salem, NC 27105-1332 | 2014-06-13 |
| 1902220379 | John Lavender | Specialist/Technologist | 1250 S Martin Luther King Jr Dr, Winston Salem, NC 27107-1370 | 2014-02-06 |
| 1932522992 | Kathryn Martin | Specialist/Technologist | 3545 Carver School Rd, Winston Salem, NC 27105-4033 | 2014-01-28 |
| 1093138307 | Jeremy S Miller | Specialist/Technologist | 3507 Midway School Rd, Winston Salem, NC 27107-8741 | 2014-01-23 |
| 1780824565 | Sarah Muslim | Specialist/Technologist | 1835 Legacy Park Apt 304, Winston Salem, NC 27103-5792 | 2009-03-06 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
Please comment or provide details below to improve the information on MRS. JACQUELINE ANN FUENTES.
| 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.