MR. TYLER REN WICKETT (NPI# 1336649409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336649409 |
| Entity Type | Individual |
| Full Name | MR. TYLER REN WICKETT |
| Credential | ATC |
| Practice Address |
1401 Presque Isle Ave Marquette MI 49855-2818 |
| Mailing Address |
303 Meyland Hall Marquette MI 49855-5391 |
| Practice Telephone | 3605931714 |
| Mailing Telephone | 3605931714 |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2018-02-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2601001755 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1401 PRESQUE ISLE AVE |
| City | MARQUETTE |
| State | MI |
| Zip Code | 49855-2818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811988959 | Michelle R Storms | Family Medicine | 1401 Presque Isle Ave, Attn: Health Center, Marquette, MI 49855-2818 | 2005-10-28 |
| 1497368443 | Samantha Marie Nelson | Student in an Organized Health Care Education/Training Program | 1401 Presque Isle Ave, Marquette, MI 49855-2818 | 2020-08-28 |
| 1326670118 | Alex Jacob Rice | Student in an Organized Health Care Education/Training Program | 1401 Presque Isle Ave, Marquette, MI 49855-2818 | 2020-02-10 |
| 1790317584 | Joel Mewbourn | Specialist/Technologist | 1401 Presque Isle Ave, Marquette, MI 49855-2818 | 2020-02-10 |
| 1194374231 | Christopher Todd Kirk | Specialist/Technologist | 1401 Presque Isle Ave, Marquette, MI 49855-2818 | 2019-09-11 |
| 1154885184 | Rachel Michelle Nye | Nurse Practitioner | 1401 Presque Isle Ave, Marquette, MI 49855-2818 | 2019-01-23 |
| 1457868853 | Victoria Dawn Mattson | Behavioral Analyst | 1401 Presque Isle Ave, Marquette, MI 49855-2818 | 2018-01-08 |
| 1609220318 | Devon Rosseau | Student in an Organized Health Care Education/Training Program | 1401 Presque Isle Ave, Marquette, MI 49855-2818 | 2016-04-19 |
| 1649633363 | Lawryn Brown | Student in an Organized Health Care Education/Training Program | 1401 Presque Isle Ave, Marquette, MI 49855-2818 | 2016-03-30 |
| 1265893606 | Alyssa Laura Vaniman | Student in an Organized Health Care Education/Training Program | 1401 Presque Isle Ave, Marquette, MI 49855-2818 | 2016-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023665064 | Scott Allen Poirier | Physician Assistant | 850 West Baraga Avenue, Marquette, MI 49855 | 2019-08-23 |
| 1730734831 | Katelyn Tourville | Physician Assistant | 1401 Presque Isle Ave-health Center, Marquette, MI 49855 | 2019-08-06 |
| 1932681095 | Katelyn Longanbach | Physical Therapist | 841 W Washington St Ste 500, Marquette, MI 49855 | 2018-09-05 |
| 1366943979 | Meijer, Inc. | Durable Medical Equipment & Medical Supplies | 3630 Us 41 W, Marquette, MI 49855 | 2018-02-28 |
| 1518466143 | Orthopaedic Surgery Associates of Marquette PC | Prosthetic/Orthotic Supplier | 841 West Washington Street, Suite 100, Marquette, MI 49855 | 2018-02-09 |
| 1376075598 | Pamela Baynton | Licensed Practical Nurse | 2292 U.S. 41 W, Marquette, MI 49855 | 2017-03-28 |
| 1548709454 | Allison Jean Czarny | Registered Nurse | 160 E Wright Pl, Marquette, MI 49855 | 2017-02-13 |
| 1629427299 | Larry Chappel | Social Worker | 210 Chippewa Square, Suite 208, Marquette, MI 49855 | 2016-06-06 |
| 1366898348 | Carla Pate | Student in an Organized Health Care Education/Training Program | 235 Hunt Hall, Marquette, MI 49855 | 2016-05-10 |
| 1922479732 | Nicholas Wujcik | Student in an Organized Health Care Education/Training Program | 504 S Fifth St, Marquette, MI 49855 | 2015-10-20 |
| Find all providers in zip 49855 | ||||
| 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 |
|---|---|---|---|---|
| 1659899128 | Brady George Aboussleman | Specialist/Technologist | 841 W Washington St Ste 200, Marquette, MI 49855-4149 | 2017-09-05 |
| 1083166839 | Alex Anthiny Zerbel I | Specialist/Technologist | 110 E Arch St, Marquette, MI 49855-3802 | 2016-10-27 |
| 1891247656 | Katherine Pryor | Specialist/Technologist | 600 Lakewood Ln, Marquette, MI 49855-9516 | 2016-10-27 |
| 1528510385 | Kelly Emard | Specialist/Technologist | 280 Whetstone Rd, Marquette, MI 49855-2423 | 2016-10-27 |
| 1609238088 | Treven Gezella | Specialist/Technologist | 110 Magers Hall, Marquette, MI 49855-5302 | 2016-03-24 |
| 1174918700 | Sarah Kramer | Specialist/Technologist | 1208 2nd St, Marquette, MI 49855-3004 | 2015-03-31 |
| 1265827067 | Cory Acker | Specialist/Technologist | 1805 Longyear Ave, Marquette, MI 49855-2116 | 2015-03-30 |
| 1306239363 | Courtney Dae Lafreniere | Specialist/Technologist | 1352 Ortman Rd, Marquette, MI 49855-9335 | 2015-03-13 |
| 1588057731 | Duane Bair | Specialist/Technologist | 1004 W Ridge St Apt 7, Marquette, MI 49855-3980 | 2015-03-12 |
| 1669865754 | Tyler Harris | Specialist/Technologist | 1401 Presque Isle Ave Apt 111, Marquette, MI 49855-2818 | 2015-03-12 |
| Find all providers in MARQUETTE | ||||
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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.