MRS. KELLEY POTILA (NPI# 1659992642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659992642 |
| Entity Type | Individual |
| Full Name | MRS. KELLEY POTILA |
| Other Name | KELLEY GALLOWAY |
| Practice Address |
255 Maggilu Ct Jefferson WI 53549-2095 |
| Practice Telephone | 7155721961 |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2020-04-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
1794-39 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
255 MAGGILU CT |
| City | JEFFERSON |
| State | WI |
| Zip Code | 53549-2095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740804913 | Anna E Warzala | Licensed Practical Nurse | Sunset Ridge Jefferson, 826 E. Reinel Street, Jefferson, Wi 53549, Jefferson, WI 53549 | 2020-06-03 |
| 1023428083 | Mary Beth Breunig | Occupational Therapist | 206 South Taft Avenue, Jefferson, WI 53549 | 2014-04-30 |
| 1841639952 | Debra Lee Schoenike | Licensed Practical Nurse | 610 S Main Street, Jefferson, WI 53549 | 2013-06-21 |
| 1073762191 | Katherine Sue Drechsler | Counselor | 1541 Annex Road, Jefferson, WI 53549 | 2008-09-12 |
| 1497960645 | Family Resources Associates Inc | Counselor | 248 S Wisconsin Drive, Jefferson, WI 53549 | 2007-05-11 |
| 1386707529 | Todd G Goldbeck | Physical Therapist | 1515 Highway 26 South, Jefferson, WI 53549 | 2006-12-19 |
| 1982780813 | Sport & Spine Clinic of Fort Atkinson Limited Partnership | Physical Therapist | 222 S Wisconsin Drive, Suite 3, Jefferson, WI 53549 | 2006-10-31 |
| 1033202528 | Marie Ann Maxwell-jones | Occupational Therapist | N3995 Annex Road, Jefferson, WI 53549 | 2006-10-02 |
| 1447216551 | Diane Mary Voelker | Registered Nurse | 224 Connelly D R, Jefferson, WI 53549 | 2006-04-26 |
| 1063477065 | Cynthia Lynn Miller | Registered Nurse | W4949 Streim Lane, Jefferson, WI 53549 | 2006-04-20 |
| Find all providers in zip 53549 | ||||
| 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 |
|---|---|---|---|---|
| 1790255396 | Irianne Nicholas | Specialist/Technologist | 1201 South Clearview Parkway, Jefferson, LA 70121 | 2018-11-27 |
| 1629582838 | Danielle Claire Blackwell | Specialist/Technologist | 540 Tucker Ave, Jefferson, LA 70121-1571 | 2017-11-27 |
| 1710344346 | James Edelman | Specialist/Technologist | Ochsner1221 S Clearview Pkwy, Jefferson, LA 70121-1011 | 2016-01-27 |
| 1548631856 | Kristina Bernard Tyson | Specialist/Technologist | 12221 South Clearview Pkwy, Jefferson, LA 70121 | 2015-10-13 |
| 1073984381 | Benjamin Franklin Evans IIi | Specialist/Technologist | Ochsner 1221 S Clearview Pkwy, Jefferson, LA 70121-1011 | 2015-10-13 |
| 1396116893 | Courtney Denoux | Specialist/Technologist | 1221 S. Clearview Pkwy, Jefferson, LA 70121 | 2015-10-12 |
| 1699146209 | Sara Moldenhauer | Specialist/Technologist | N3661 County Road K, Jefferson, WI 53549-9418 | 2015-10-08 |
| 1497147839 | Nicholas Holtgrieve | Specialist/Technologist | 1221 S. Clearview Parkway, Jefferson, LA 70121 | 2015-02-23 |
| 1629695200 | Blake Ryan Hockaday | Specialist/Technologist | 1201 S Clearview Pkwy Bldg B, Jefferson, LA 70121-1015 | 2020-06-30 |
| 1598389488 | Jacquelyn Kate Nelson | Specialist/Technologist | 1201 S Clearview Pkwy, Jefferson, LA 70121-1015 | 2020-06-05 |
| Find all providers in JEFFERSON | ||||
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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.