AUSTYN LYNNELL BOULWARE (NPI# 1326504994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326504994 |
| Entity Type | Individual |
| Full Name | AUSTYN LYNNELL BOULWARE |
| Practice Address |
23225 Thorncliffe St Southfield MI 48033-6559 |
| Practice Telephone | 5869172338 |
| Mailing Telephone | 5869172338 |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2019-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
B460084564641 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
23225 THORNCLIFFE ST |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48033-6559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013531243 | Kenicka Harper | Case Manager/Care Coordinator | 2270 W Nine Mile Rd, Detroit, MI 48033 | 2020-06-03 |
| 1154955292 | Judy C Staples | Registered Nurse | 23800 West 10 Mile Road, Ste. 110, Southfield, MI 48033 | 2020-02-27 |
| 1578193827 | Axel Lee Gruenberg | Peer Specialist | 221790 West 9 Mile, Southfield, MI 48033 | 2020-01-24 |
| 1851958706 | William Beaumont Hospital | Clinic/Center | 26901 Beaumont Blvd., D - 5, Community Health, Southfield, MI 48033 | 2019-05-28 |
| 1396302857 | William Beaumont Hospital | Clinic/Center | Beaumont Service Center, 26901 Beaumont Blvd, Community Health, D - 5, Southfield, MI 48033 | 2019-05-21 |
| 1700442597 | Botsford General Hospital | Clinic/Center | 26901 Beaumont Blvd, Beaumont Service Center, Community Health, D - 5, Southfield, MI 48033 | 2019-05-16 |
| 1558862433 | Oakwood Accountable Care Organization, LLC | Preferred Provider Organization | 26901 Beaumont Blvd., Southfield, MI 48033 | 2018-02-26 |
| 1891228904 | Brandi Becker-wright | Social Worker | 25200 Telegraph Rd Ste 100, Southfield, MI 48033 | 2017-04-05 |
| 1003362252 | Mark Kline | Registered Nurse | 22170 W Nine Mile Rd, Southfield, MI 48033 | 2016-08-28 |
| 1033534797 | Jessica Savageau | Social Worker | 22170 W 9 Mile, Southfield, MI 48033 | 2014-03-04 |
| Find all providers in zip 48033 | ||||
| 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 |
|---|---|---|---|---|
| 1194272690 | Brittany Tyler | Specialist/Technologist | 29381 Leemoor Dr, Southfield, MI 48076 | 2016-09-01 |
| 1629474648 | Timothy Aaron Stanley Fracassi | Specialist/Technologist | 28650 Lahser Rd, Southfield, MI 48034-2020 | 2014-11-18 |
| 1548684830 | Rebecca Austin | Specialist/Technologist | 26935 Northwestern Hwy, Southfield, MI 48033 | 2014-02-07 |
| 1235368689 | Janet Balowski | Specialist/Technologist | 22250 Providence Dr, Suite 400, Southfield, MI 48075-4825 | 2009-07-07 |
| 1598809428 | Ebonnie Camille West | Specialist/Technologist | 24901 Northwestern Hwy, Southfield, MI 48075-2203 | 2007-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467052027 | Brianna Redmond | Specialist/Technologist | 2145 Sunset Ln, Saginaw, MI 48604-2443 | 2020-10-31 |
| 1386243913 | Carrie A Lindsay | Specialist/Technologist | 4761 Highland Rd, Waterford, MI 48328-1178 | 2020-10-24 |
| 1528667128 | Bethany Lynn York | Specialist/Technologist | 1461 Crest Rd, Gladwin, MI 48624-7606 | 2020-10-23 |
| 1255930962 | Benjamin Foddrill | Specialist/Technologist | 7380 Clearview Dr, Caledonia, MI 49316-9309 | 2020-10-22 |
| 1427656040 | Travis Zaborowski | Specialist/Technologist | 2412 W 4th Ave, Sault Sainte Marie, MI 49783-1212 | 2020-10-15 |
| 1730787912 | Batoul Kassem | Specialist/Technologist | 6045 Steadman St, Dearborn, MI 48126-2052 | 2020-10-11 |
| 1801493697 | Janelle Dorsey | Specialist/Technologist | 24311 Ithaca St, Oak Park, MI 48237-1788 | 2020-10-05 |
| 1194332379 | Bryan Keith Baines Sr. | Specialist/Technologist | 4333 John R Rd, Troy, MI 48085-3681 | 2020-09-30 |
| 1205443553 | Emma Weber | Specialist/Technologist | 7776 Percheron St, Kalamazoo, MI 49009-5990 | 2020-09-29 |
| 1295342616 | Margaret Ann Gilbeau | Specialist/Technologist | 38051 Metro Villa Dr Unit 114f, Harrison Township, MI 48045-3553 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHFIELD |
| Zip Code | 48033 |
Please comment or provide details below to improve the information on AUSTYN LYNNELL BOULWARE.
| 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.