MRS. BETH ANN HERRELL


Address: 3946 Ice Way, Fort Wayne, IN 46808
Phone: 2602664007

MRS. BETH ANN HERRELL (NPI# 1619945888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619945888
Entity Type Individual
Full Name MRS. BETH ANN HERRELL
Credential MS, ATC, LAT, CSCS
Practice Address 3946 Ice Way
Fort Wayne
IN 46808
Practice Telephone 2602664007
Mailing Telephone 2602664007
Enumeration Date 2006-03-14
Last Update Date 2018-03-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2255A2300X Specialist/Technologist
Specialization: Athletic Trainer
36000171A IN Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
11130 Parkview Circle Dr, Fort Wayne, IN 468451735 2603594287 2603594108

Office Location

Street Address 3946 ICE WAY
City FORT WAYNE
State IN
Zip Code 46808

Providers in the same location

NPI Name Taxonomy Address Enumeration
1184263857 Calvin Bissell Specialist/Technologist 3946 Ice Way, Fort Wayne, IN 46805-1018 2019-12-30
1639727068 Briana Marie Wood Specialist/Technologist 3946 Ice Way, Fort Wayne, IN 46805-1018 2019-08-28
1215583703 Lauren Elizabeth Ehle Specialist/Technologist 3946 Ice Way, Fort Wayne, IN 46805-1018 2019-08-12
1932767530 Amanda Nicole Toney Specialist/Technologist 3946 Ice Way, Fort Wayne, IN 46805-1018 2019-05-30
1750851168 Tyler Cheney Specialist/Technologist 3946 Ice Way, Fort Wayne, IN 46808 2018-11-28
1487123550 Michaela Mcguire Specialist/Technologist 3946 Ice Way, Fort Wayne, IN 46808 2018-11-19
1861961088 Olivia Marquardt Specialist/Technologist 3946 Ice Way, Fort Wayne, IN 46808 2018-11-16
1184191652 Lynn Marie Miller Specialist/Technologist 3946 Ice Way, Fort Wayne, IN 46805-1018 2018-11-01
1962989640 Jillian Ann Hacker Specialist/Technologist 3946 Ice Way, Fort Wayne, IN 46805-1018 2018-07-25
1447753140 Adam Gibson Specialist/Technologist 3946 Ice Way, Fort Wayne, IN 46805-1018 2018-03-09
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1295347102 Austin Hartzog Pharmacist 5110 Value Drive, Fort Wayne, IN 46808 2020-08-21
1407358377 Bryan Black Specialist/Technologist 3946 Ice Way Fort Wayne, Fort Wayne, IN 46808 2018-03-06
1326557877 Kimberly K Kolb Occupational Therapy Assistant 1431 Runnion Ave, Fort Wayne, IN 46808 2017-09-28
1396142063 Christina Ryder Specialist/Technologist 3946 Iceway, Fort Wayne, IN 46808 2014-11-25
1912090440 Neighborcare of Indiana, LLC Pharmacy 3402 Congressional Pkwy, Ft. Wayne, IN 46808 2006-10-02
1568458990 Carolyn Warner Greer Obstetrics & Gynecology 1415 Directors Row, Fort Wayne, IN 46808 2005-09-21
1013341890 Matthew Gotsch Dentist 919 Florence Ave, Fort Wayne, IN 46808 2013-08-28
1548608821 Costco Wholesale Corporation Pharmacy 5110 Value Dr, Fort Wayne, IN 46808 2013-06-10
1861741043 Daniel D Schreck Counselor 2100 Goshen Rd, Fort Wayne, IN 46808 2012-09-05
1184715567 Lilioza Maria Gzyl Pediatrics 1415 Directors Row, Ste 11a, Fort Wayne, IN 46808 2006-09-28
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Taxonomy Information

Taxonomy Code 2255A2300X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Specialist/Technologist
Specialization Athletic Trainer

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1699308700 Jennifer N Peppler Specialist/Technologist 3434 Kirkfield Dr, Fort Wayne, IN 46815-5972 2020-02-17
1710519392 Mitchell Mckay Enyart Specialist/Technologist 1617 Randford Pl, Fort Wayne, IN 46815-7635 2020-02-11
1003448671 Chelsea L Harrison Specialist/Technologist 6716 Ramblewood Ct Apt L, Fort Wayne, IN 46835-1760 2020-02-11
1457983223 Kayla Grotrian Specialist/Technologist 5440 Evard Rd, Fort Wayne, IN 46835-1796 2020-02-10
1730711680 Danielle Rebecca Patton Specialist/Technologist 13303 Hawks View Blvd, Fort Wayne, IN 46845-8726 2020-02-09
1780220046 Kelly Grayson Specialist/Technologist 1300 E Washington Center Rd, Fort Wayne, IN 46825-4556 2019-11-21
1265093280 Emily Maria Giorgi Specialist/Technologist 2101 E Coliseum Blvd Ste 100, Fort Wayne, IN 46805-1499 2019-06-21
1194209791 Autumn Brooke Meece Specialist/Technologist 5801 Meadows Dr Apt E, Fort Wayne, IN 46804-7639 2018-09-19
1407358377 Bryan Black Specialist/Technologist 3946 Ice Way Fort Wayne, Fort Wayne, IN 46808 2018-03-06
1275049686 Julianna Davis Specialist/Technologist 615 Vance Ave, Fort Wayne, IN 46805-2143 2017-12-20
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Competitor

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City FORT WAYNE
Zip Code 46808

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Dataset Information

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.

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