MRS. JILL GREEN PEDERSEN (NPI# 1568400638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568400638 |
| Entity Type | Individual |
| Full Name | MRS. JILL GREEN PEDERSEN |
| Credential | ATC |
| Practice Address |
407 E Russell Ave Bldg. A, Suite 4 Warrensburg MO 64093-1242 |
| Mailing Address |
304 Knoll Dr Warrensburg MO 64093-2002 |
| Practice Telephone | 6604294700 |
| Practice Fax Number | 6604290500 |
| Mailing Telephone | 6607478466 |
| Mailing Fax Number | 6604290500 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2000173562 | MO | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821347436 | Jill Ann Pedersen | Social Worker | 281 2nd Street, Jersey City, NJ 07302 | 2012-08-29 |
| 1619533866 | Jill Pedersen | Speech-Language Pathologist | 6395 Old Niagara Rd, Lockport, NY 14094-1421 | 2019-05-14 |
| Street Address |
407 E RUSSELL AVE BLDG. A, SUITE 4 |
| City | WARRENSBURG |
| State | MO |
| Zip Code | 64093-1242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063037893 | Christopher Scott Lichte | Physical Therapist | 407 E Russell Ave, Building A Suite 6, Warrensburg, MO 64093-1242 | 2020-06-08 |
| 1437524907 | Kimberly Retherford | Counselor | 407 E Russell Ave, Ste 4a, Warrensburg, MO 64093-1242 | 2015-12-09 |
| 1710310453 | Haley Burnside | Physical Therapist | 407 E Russell Ave, Bldg A, Suite 6, Warrensburg, MO 64093-1242 | 2013-08-16 |
| 1306137369 | John Peter Ozias | Counselor | 407 E Russell Ave, Ste A5, Warrensburg, MO 64093-1242 | 2011-04-26 |
| 1073827911 | Michael Jon Kelledes | Counselor | 407 E Russell Ave, Ste A5, Warrensburg, MO 64093-3107 | 2010-08-03 |
| 1508802851 | Shawn Kevin Roach | Physical Therapist | 407 E Russell Ave, Bldg A Ste 6, Warrensburg, MO 64093-1242 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841752144 | Joshua Tyler Allman | Specialist/Technologist | 500 South Maguire Street, Warrensburg, MO 64093 | 2019-04-04 |
| 1477015220 | Kelly Maurine Warford | Specialist/Technologist | Morrow 125, Warrensburg, MO 64093 | 2019-04-02 |
| 1104388958 | Kaitlyn Nicole Edison | Specialist/Technologist | 108 W South Street, Morrow 125, Warrensburg, MO 64093 | 2019-04-02 |
| 1891257663 | Mckenzie Higgins | Student in an Organized Health Care Education/Training Program | University of Central Missouri Morrow 125, Warrensburg, MO 64093 | 2019-04-02 |
| 1780142901 | Scott C Huff | Marriage & Family Therapist | Uhc 102, Warrensburg, MO 64093 | 2019-03-06 |
| 1144701079 | Summers Pharmacy of Warrensburg, LLC | Pharmacy | 611 Burkarth Rd, Warrensburg, MO 64093 | 2018-08-28 |
| 1174010037 | Stephen Joseph Sattler | Student in an Organized Health Care Education/Training Program | 108 West South Street, Morrow 125, Warrensburg, MO 64093 | 2018-04-17 |
| 1871090522 | Leah Harold | Student in an Organized Health Care Education/Training Program | 108 W. South Street, Morrow 125, Warrensburg, MO 64093 | 2018-04-10 |
| 1396245544 | Patricia J Turner | Speech-Language Pathologist | 201 S Holden Street, Po Box 638, Warrensburg, MO 64093 | 2018-02-14 |
| 1467952721 | Corie Z'hane Williams | Student in an Organized Health Care Education/Training Program | 500 S Maguire St, Warrensburg, MO 64093 | 2018-02-13 |
| Find all providers in zip 64093 | ||||
| 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 |
|---|---|---|---|---|
| 1841752144 | Joshua Tyler Allman | Specialist/Technologist | 500 South Maguire Street, Warrensburg, MO 64093 | 2019-04-04 |
| 1477015220 | Kelly Maurine Warford | Specialist/Technologist | Morrow 125, Warrensburg, MO 64093 | 2019-04-02 |
| 1104388958 | Kaitlyn Nicole Edison | Specialist/Technologist | 108 W South Street, Morrow 125, Warrensburg, MO 64093 | 2019-04-02 |
| 1477044907 | Brian K Henry | Specialist/Technologist | 1616 Roanoke Dr, Warrensburg, MO 64093-8915 | 2018-05-21 |
| 1154798239 | Brian Joseph Hughes | Specialist/Technologist | 108 W South St, Warrensburg, MO 64093-2324 | 2015-08-25 |
| 1700485166 | Rina Nagai | Specialist/Technologist | 108 W South St, Warrensburg, MO 64093-2324 | 2020-10-18 |
| 1447895016 | Brennen Hudson | Specialist/Technologist | 108 W South St, Warrensburg, MO 64093-2324 | 2019-11-07 |
| 1700446564 | Amanda Ralton | Specialist/Technologist | 108 W South St, Warrensburg, MO 64093-2324 | 2019-06-14 |
| 1689152258 | Megan Laurel Batusic | Specialist/Technologist | 540 E Young Ave Ste E, Warrensburg, MO 64093-1250 | 2018-08-05 |
| 1366949265 | Hally Nelson | Specialist/Technologist | 108 W South St, Warrensburg, MO 64093-2324 | 2018-04-09 |
| Find all providers in WARRENSBURG | ||||
| City | WARRENSBURG |
| Zip Code | 64093 |
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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.