MR. GREGORY W SOUTHWORTH (NPI# 1396097275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396097275 |
| Entity Type | Individual |
| Full Name | MR. GREGORY W SOUTHWORTH |
| Credential | LATC MED |
| Practice Address |
240 Sykes St Palmer MA 01069-1225 |
| Practice Telephone | 4132839701 |
| Mailing Telephone | 4132839701 |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2012-10-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
115 | MA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 2255A2300X | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831439546 | Gregory Noel Southworth | Counselor | 422 E Lamar Blvd Ste 108, Arlington, TX 76011-3604 | 2013-02-18 |
| Street Address |
240 SYKES ST |
| City | PALMER |
| State | MA |
| Zip Code | 01069-1225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780704155 | Pathfinder Regional Vocational High School District | Local Education Agency (LEA) | 240 Sykes St, Palmer, MA 01069-1225 | 2007-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962979328 | Jacqueline Pahl | Social Worker | 11 Oakland St., Palmer, MA 01069 | 2018-10-24 |
| 1891277240 | Katherine Beliveau | Developmental Therapist | 1581 N. Main Street, Palmer, MA 01069 | 2018-09-02 |
| 1730606740 | Jordan Elizabeth Pike | Physician Assistant | 40 Wirght, Palmer, MA 01069 | 2017-08-30 |
| 1265880405 | Brittany Ford | Specialist/Technologist | 4105 Main St, Palmer, MA 01069 | 2016-05-27 |
| 1417263021 | Deborah Lee Stroetzel I | Audiologist-Hearing Aid Fitter | 40 Wright St., Palmer, MA 01069 | 2010-08-20 |
| 1063635399 | Department of Developmental Services | Intermediate Care Facility, Mentally Retarded | Monson Dev Cntr, 175 State Ave, Palmer, MA 01069 | 2007-04-11 |
| 1124149273 | Pruushotam Puri | Surgery | Wright Street, Palmer, MA 01069 | 2007-04-03 |
| 1679582019 | Richard Michael Gondek | Dentist | 1436 Main St, Palmer, MA 01069 | 2006-08-05 |
| 1083649222 | Jessica R Senecal-bennett | Social Worker | 42 Wright St, Palmer, MA 01069 | 2006-07-12 |
| 1396770632 | Daniel Shapiro | Social Worker | Wing Memorial Hospital Griswold Center, 40 Wright Street, Palmer, MA 01069 | 2006-07-12 |
| Find all providers in zip 01069 | ||||
| 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 |
|---|---|---|---|---|
| 1265880405 | Brittany Ford | Specialist/Technologist | 4105 Main St, Palmer, MA 01069 | 2016-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184225682 | Jacob Hebert | Specialist/Technologist | 177 Wenonah Rd, Longmeadow, MA 01106-1929 | 2020-11-03 |
| 1700486693 | Mark Comstock | Specialist/Technologist | 74 Union Park St, Boston, MA 02118-2142 | 2020-10-29 |
| 1962000422 | Allison Damigella | Specialist/Technologist | 20 Cobblestone Ln, Bridgewater, MA 02324-2277 | 2020-10-15 |
| 1669088712 | Ryan Donovan | Specialist/Technologist | 4 Paul Ave, Peabody, MA 01960-2620 | 2020-09-23 |
| 1619583119 | Seth Travers | Specialist/Technologist | 179 Wimbleton Dr, Longmeadow, MA 01106-2744 | 2020-09-20 |
| 1306451091 | Stephanie Wilson | Specialist/Technologist | 315 Turnpike St Stop 2247, North Andover, MA 01845-5800 | 2020-09-10 |
| 1467067116 | Devon Choi | Specialist/Technologist | Merrimack College, 315 Turnpike St, North Andover, MA 01845-0184 | 2020-09-10 |
| 1295349140 | Katelyn Charlotte Richardson | Specialist/Technologist | 2002 Lords Ct, Wilmington, MA 01887-4514 | 2020-09-08 |
| 1386256360 | William Conrad Desjardins | Specialist/Technologist | 20 Manhattan Dr, Burlington, MA 01803-1905 | 2020-08-20 |
| 1942812128 | Samantha Norman Kheboian | Specialist/Technologist | 71 Lakeshore Ave, Beverly, MA 01915-1907 | 2020-08-19 |
| Find all providers with the same taxonomy | ||||
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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.