MR. ETHAN ROBERTS (NPI# 1447666037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447666037 |
| Entity Type | Individual |
| Full Name | MR. ETHAN ROBERTS |
| Credential | ATC |
| Practice Address |
1916 Haughton Ave Apt 1 North Mankato MN 56003-1440 |
| Practice Telephone | 5079957937 |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2014-07-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
D834044851615 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497193585 | Ethan Roberts | Student in an Organized Health Care Education/Training Program | 722 Norvell St, El Cerrito, CA 94530-3246 | 2013-06-11 |
| 1578647517 | Ethan Roberts | Physical Therapist | 11110 Medical Campus Rd, 201, Hagerstown, MD 21742-6700 | 2006-10-25 |
| Street Address |
1916 HAUGHTON AVE APT 1 |
| City | NORTH MANKATO |
| State | MN |
| Zip Code | 56003-1440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609391796 | Chelsea Lynn Homan | Registered Nurse | 1961 Premier Dr #340, Mankato, MN 56003 | 2017-08-09 |
| 1700115649 | Oscar Donald Anderson | Ophthalmology | 2000 Roe Crest Dr, No Mankato, MN 56003 | 2009-12-23 |
| 1942434121 | Leah Rose Breit | Family Medicine | 1575 Lookout Drive, North Mankato, MN 56003 | 2009-05-04 |
| 1144792664 | Alexis Lise Cote-sands | Social Worker | 342 Belgrade Ave, North Mankato, MN 56003 | 2018-12-21 |
| 1164949863 | Ashlee Harriman | Physical Therapist | 1681 Commerce Dr, North Mankato, MN 56003 | 2017-08-24 |
| 1235685439 | Sagan Dobie | Physician Assistant | 1575 Lookout Dr, North Mankato, MN 56003 | 2016-08-28 |
| 1457687477 | Bridget Danielle Pollack-naber | Counselor | 360 Pierce Ave, Suite 209 Sioux Trails Mental Health Center, North Mankato, MN 56003 | 2009-10-27 |
| 1194884478 | Angela M Schuck | Dentist | 1400 Lookout Drive, North Mankato, MN 56003 | 2006-12-06 |
| 1881769198 | North Mankato Family Dentistry Pa | Dentist | 1400 Lookout Drive, North Mankato, MN 56003 | 2006-11-21 |
| 1740355064 | Keith P Flack | Dentist | 1400 Lookout Drive, North Mankato, MN 56003 | 2006-11-21 |
| Find all providers in zip 56003 | ||||
| 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 |
|---|---|---|---|---|
| 1407224009 | Lindsey Chambers | Specialist/Technologist | 837 Wall St, North Mankato, MN 56003-3040 | 2015-09-13 |
| 1538216650 | Beth Ann Bushie | Specialist/Technologist | 1681 Commerce Dr, North Mankato, MN 56003-1913 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092165 | Jamie Lynn Erickson | Specialist/Technologist | 43628 374th Ln, Aitkin, MN 56431-4027 | 2020-10-27 |
| 1760082044 | Craig Daniel Merten | Specialist/Technologist | 5045 Division Ave # 5575, White Bear Lake, MN 55110-2663 | 2020-10-27 |
| 1154928927 | Heidi Frey | Specialist/Technologist | 4554 Lake Park Ct, Eagan, MN 55122-2515 | 2020-10-05 |
| 1851906887 | Teddy Ray Gildersleeve | Specialist/Technologist | 37320 Oriole Ave, Lindstrom, MN 55045-9109 | 2020-09-15 |
| 1851906697 | Tadd William Berg | Specialist/Technologist | 2415 W 9th St, Duluth, MN 55806-1150 | 2020-09-09 |
| 1952916793 | Megan Marie Hautajarvi | Specialist/Technologist | 2536 Peace Dr, Duluth, MN 55811-2971 | 2020-09-09 |
| 1871108795 | Bryce Mershon Beamish | Specialist/Technologist | 3501 Lowell St, Wayzata, MN 55391-3411 | 2020-09-09 |
| 1043825961 | Kevin Eskuri | Specialist/Technologist | 8090 172nd St W, Lakeville, MN 55044-6206 | 2020-09-09 |
| 1952916876 | Elizabeth Marie Altendorf | Specialist/Technologist | 1621 397th Ave Ne, Stanchfield, MN 55080-3303 | 2020-09-09 |
| 1699380519 | Kourtney Jean Palmi | Specialist/Technologist | 4922 Howard Gnesen Rd, Duluth, MN 55803-2710 | 2020-09-09 |
| Find all providers with the same taxonomy | ||||
| City | NORTH MANKATO |
| Zip Code | 56003 |
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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.