JILLIAN FRANCES NICHOLSON (NPI# 1669795753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669795753 |
| Entity Type | Individual |
| Full Name | JILLIAN FRANCES NICHOLSON |
| Credential | ATC, LAT |
| Practice Address |
9601 Townline Rd Minocqua WI 54548-9099 |
| Mailing Address |
11796 State Highway 70 Minocqua WI 54548-9548 |
| Practice Telephone | 7153581490 |
| Practice Fax Number | 7153581490 |
| Mailing Telephone | 7153581886 |
| Mailing Fax Number | 7153581490 |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2012-11-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
1059-039 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BOC CERTIFICATION NUMBER | 2000000365 | 01 | |
| WI | WI STATE LICENSURE | 1059-039 | 01 |
| Street Address |
9601 TOWNLINE RD |
| City | MINOCQUA |
| State | WI |
| Zip Code | 54548-9099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295721041 | Deno N. Karegeannes | Physician Assistant | 9601 Townline Rd, Minocqua, WI 54548-9099 | 2005-09-26 |
| 1750934493 | Mchs Hospitals, Inc. | Clinic/Center | 9601 Townline Rd, Minocqua, WI 54548-9099 | 2019-07-22 |
| 1508351099 | Lauren Erica Treml | Optometrist | 9601 Townline Rd, Minocqua, WI 54548 | 2018-06-27 |
| 1003313230 | Colleen Ann Mueller | Nurse Practitioner | 9601 Townline Rd, Minocqua, WI 54548-9099 | 2018-04-13 |
| 1205355351 | Sami Ahmed | Family Medicine | 9601 Townline Rd, Minocqua, WI 54548 | 2017-09-10 |
| 1699136085 | Peter Thomas Keenan | Clinical Neuropsychologist | 9601 Townline Rd, Minocqua, WI 54548-9099 | 2016-03-11 |
| 1568820199 | Alexa Boersen | Physician Assistant | 9601 Townline Rd, Minocqua, WI 54548-9099 | 2016-02-10 |
| 1881063329 | Marshfield Clinic Inc | Clinic/Center | 9601 Townline Rd, Minocqua, WI 54548-9099 | 2015-09-15 |
| 1184009466 | Patti Ann Brown | Physician Assistant | 9601 Townline Rd, Minocqua, WI 54548-9099 | 2015-07-28 |
| 1174916720 | David Fay Lee | Radiology | 9601 Townline Rd, Minocqua, WI 54548 | 2015-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376197665 | Mchs Hospitals, Inc. | General Acute Care Hospital | 9576 Highway 70, Minocqua, WI 54548 | 2019-07-25 |
| 1922665637 | Ben Lonsdorf | Dentist | 9547 Lakeview Drive #200, Minocqua, WI 54548 | 2019-05-29 |
| 1396194460 | Samantha M Jeffery | Dentist | 5222 Us-51 N, Mercer, WI 54548 | 2016-06-08 |
| 1144608068 | Laura Gifford | Registered Nurse | 9845 Wintergreen Drive, Minocqua, WI 54548 | 2015-05-12 |
| 1174942353 | Jeffrey Clark | Pediatrics | 9576 Hwy 70, Department of Pediatrics, Minocqua, WI 54548 | 2014-04-15 |
| 1609136936 | Joseph M Pilarski | Chiropractor | 9792 Wi-70, Minocqua, WI 54548 | 2012-05-21 |
| 1225307242 | Minocqua Optical | Eyewear Supplier (Equipment, not the service) | 419 Chippewa St, Minocqua, WI 54548 | 2011-12-20 |
| 1073849840 | Frederick Alfred Melms Jr. | Family Medicine | 7380 Timber Lane, Minocqua, WI 54548 | 2009-10-28 |
| 1588820542 | Nicholas Bodmer | Radiology | 9576 Wi-70, Minocqua, WI 54548 | 2008-07-30 |
| 1063694545 | Gina M White | Counselor | 102 Front Street, Minocqua, WI 54548 | 2007-11-27 |
| Find all providers in zip 54548 | ||||
| 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 |
|---|---|---|---|---|
| 1639503956 | Amanda H. Williamson | Specialist/Technologist | 9601 Townline Rd, Minocqua, WI 54548-9099 | 2013-08-22 |
| 1093082091 | Cassandra J. Tiltges | Specialist/Technologist | 9601 Townline Rd, Minocqua, WI 54548-9099 | 2011-11-19 |
| 1750683751 | Eric M. Prom | Specialist/Technologist | 9601 Townline Rd, Minocqua, WI 54548-9099 | 2010-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427657329 | Tyler John Friis | Specialist/Technologist | 1514 E Keystone Ln, Appleton, WI 54913-7162 | 2020-10-21 |
| 1184222085 | Ryan James Mcnamara | Specialist/Technologist | 28914 Golden Cir, Waterford, WI 53185-1197 | 2020-10-13 |
| 1770198699 | Tanner Sterling | Specialist/Technologist | 2538 E Garrison Rd, Foxboro, WI 54836-9507 | 2020-09-09 |
| 1922626670 | Eric William Brostrom | Specialist/Technologist | 3305 Lilly Rd, Brookfield, WI 53005-7608 | 2020-07-09 |
| 1174146690 | Brycen Valiga | Specialist/Technologist | 4477 S 113th St, Greenfield, WI 53228-2566 | 2020-05-19 |
| 1104448307 | Xeing Randy Yang | Specialist/Technologist | 2207 Namekagon St, Hudson, WI 54016-9426 | 2020-05-11 |
| 1073134615 | Brian Wood | Specialist/Technologist | 1950 Washington St, Grafton, WI 53024-2103 | 2020-05-06 |
| 1124649751 | Cody Scott Tesch | Specialist/Technologist | 6680 N Teutonia Ave, Milwaukee, WI 53209-3117 | 2020-05-05 |
| 1659992642 | Kelley Potila | Specialist/Technologist | 255 Maggilu Ct, Jefferson, WI 53549-2095 | 2020-04-30 |
| 1366070708 | Claire Duwell | Specialist/Technologist | 9111 W Bluemound Rd, Milwaukee, WI 53226-4506 | 2020-03-31 |
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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.