EMMA NICOLE SELF (NPI# 1558995407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558995407 |
| Entity Type | Individual |
| Full Name | EMMA NICOLE SELF |
| Practice Address |
2001 Alford Park Dr Kenosha WI 53140-1994 |
| Mailing Address |
401 Checker Dr Buffalo Grove IL 60089-1643 |
| Practice Telephone | 2243308871 |
| Mailing Telephone | 2243088871 |
| Enumeration Date | 2020-03-01 |
| Last Update Date | 2020-03-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2001 ALFORD PARK DR |
| City | KENOSHA |
| State | WI |
| Zip Code | 53140-1994 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295723849 | Laurie Anne Jensen | Specialist/Technologist | 2001 Alford Park Dr, Kenosha, WI 53140-1929 | 2005-10-07 |
| 1730796509 | Zachary Tavs | Specialist/Technologist | 2001 Alford Park Dr, Kenosha, WI 53140-1927 | 2020-09-25 |
| 1376179101 | Dan Ruffner | Specialist/Technologist | 2001 Alford Park Dr, Kenosha, WI 53140-1994 | 2020-03-12 |
| 1619501442 | Jacob Paul Boucher | Student in an Organized Health Care Education/Training Program | 2001 Alford Park Dr, Kenosha, WI 53140-1927 | 2020-03-02 |
| 1699309534 | Hannah Lyn Midlock | Specialist/Technologist | 2001 Alford Park Dr, Kenosha, WI 53140-1994 | 2020-03-01 |
| 1043844988 | Thomas Joseph Green IIi | Student in an Organized Health Care Education/Training Program | 2001 Alford Park Dr, Kenosha, WI 53140-1994 | 2020-03-01 |
| 1457985384 | Alana Rose Radley | Specialist/Technologist | 2001 Alford Park Dr, Kenosha, WI 53140-1994 | 2020-02-29 |
| 1548894462 | Alexandre Lacrosse | Specialist/Technologist | 2001 Alford Park Dr, Kenosha, WI 53140-1927 | 2020-02-29 |
| 1154988566 | Vanesa Acosta | Student in an Organized Health Care Education/Training Program | 2001 Alford Park Dr, Kenosha, WI 53140-1927 | 2019-05-21 |
| 1285290809 | Kelsey Anne Welch | Student in an Organized Health Care Education/Training Program | 2001 Alford Park Dr, Kenosha, WI 53140-1994 | 2019-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225663396 | Lydia Zopf | Counselor | 2001 Alford Park Dr., Carthage College, Kenosha, WI 53140 | 2020-03-09 |
| 1952949406 | Rotate Rehabilitation and Performance | Physical Therapist | 5606 6th Avenue Suite Ll9, Kenosha, WI 53140 | 2019-12-16 |
| 1134778590 | Brenda Chiapetta | Registered Nurse | 3233 23rd Ave, Kenosha, WI 53140 | 2019-09-09 |
| 1275003394 | Kimberly Shaffner | Family Medicine | 4536 22nd Avenue, Kenosha, WI 53140 | 2018-12-01 |
| 1659863389 | Bart L Mengo | Contractor | 1715 60th Street, Kenosha, WI 53140 | 2018-05-30 |
| 1093182941 | Guided Wellness Counseling | Community/Behavioral Health | 1112 56th St, Kenosha, WI 53140 | 2015-08-26 |
| 1376970764 | Stacey L Andersen | Acupuncturist | 5603 7th Ave, Kenosha, WI 53140 | 2013-10-01 |
| 1841467438 | Deborah Schwerdtfeger | Occupational Therapy Assistant | 3415 Sheridan Road, Woodstock Rehab Dept, Kenosha, WI 53140 | 2008-05-13 |
| 1942492020 | Rebecca Ann Burdette | Counselor | 920 60th Street, Renosha, WI 53140 | 2007-08-13 |
| 1851598619 | Aurora Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 2707 15th Place, Kenosha, WI 53140 | 2007-06-27 |
| Find all providers in zip 53140 | ||||
| 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 |
|---|---|---|---|---|
| 1972015758 | Samantha Jane Atkielski | Specialist/Technologist | 6911 53rd St, Kenosha, WI 53144-3772 | 2017-11-01 |
| 1184088742 | David James O'loughlin | Specialist/Technologist | 9436 69th St, Kenosha, WI 53142-8111 | 2016-04-11 |
| 1346637055 | Becka Owens | Specialist/Technologist | 1465 Sheridan Rd, Apt 16, Kenosha, WI 53140-4444 | 2015-04-20 |
| 1871882944 | Katie Lynn Bowers | Specialist/Technologist | 900 Wood Rd, Kenosha, WI 53144-1199 | 2011-03-29 |
| 1487973095 | Kevan M Creighton | Specialist/Technologist | 7201 120th Ave, Kenosha, WI 53142-7305 | 2010-05-21 |
| 1639202971 | Joseph J Olszewski | Specialist/Technologist | 4506 79th St, Kenosha, WI 53142-4519 | 2007-03-14 |
| 1265580476 | David Koch | Specialist/Technologist | 3621 59th St, Kenosha, WI 53144-6921 | 2007-01-07 |
| 1295723849 | Laurie Anne Jensen | Specialist/Technologist | 2001 Alford Park Dr, Kenosha, WI 53140-1929 | 2005-10-07 |
| 1730796509 | Zachary Tavs | Specialist/Technologist | 2001 Alford Park Dr, Kenosha, WI 53140-1927 | 2020-09-25 |
| 1376179101 | Dan Ruffner | Specialist/Technologist | 2001 Alford Park Dr, Kenosha, WI 53140-1994 | 2020-03-12 |
| Find all providers in KENOSHA | ||||
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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.