MATEA MICHELLE DEPOE (NPI# 1689117194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689117194 |
| Entity Type | Individual |
| Full Name | MATEA MICHELLE DEPOE |
| Credential | M.S, LAT, ATC |
| Practice Address |
2360 Mullan Rd Suite D Missoula MT 59808-1811 |
| Mailing Address |
2200 Great Northern Ave Apt B16 Missoula MT 59808-1605 |
| Practice Telephone | 4065424702 |
| Mailing Telephone | 4062079149 |
| Enumeration Date | 2016-12-01 |
| Last Update Date | 2016-12-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
ATR-LAT-LIC-1470 | MT | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2360 MULLAN RD SUITE D |
| City | MISSOULA |
| State | MT |
| Zip Code | 59808-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497747802 | Kay Lynn Kramer | Occupational Therapist | 2360 Mullan Rd, Ste D, Missoula, MT 59808-1811 | 2005-08-22 |
| 1891354684 | Tasha Nichole Kohlwes | Specialist/Technologist | 2360 Mullan Rd, Missoula, MT 59808-1811 | 2019-06-06 |
| 1306327317 | Sydney Williams | Physical Therapist | 2360 Mullan Rd, Missoula, MT 59808-1811 | 2018-08-27 |
| 1144754938 | University of Utah Adult Services | Orthopaedic Surgery | 2360 Mullan Rd, Suite C, Missoula, MT 59808-1811 | 2017-04-18 |
| 1023542388 | University of Utah Pediatric Services | Pediatrics | 2360 Mullan Rd, Sutie C, Missoula, MT 59808-1811 | 2017-04-13 |
| 1972900157 | Vincent Keeney | Physician Assistant | 2360 Mullan Rd, Ste C, Missoula, MT 59808-1811 | 2014-12-03 |
| 1497158208 | Emily Beatrice Smith | Dietitian, Registered | 2360 Mullan Rd, Suite C, Missoula, MT 59808-1811 | 2014-10-07 |
| 1588079016 | Cynthia Deann Cleveland | Physical Therapist | 2360 Mullan Rd, Suite C, Missoula, MT 59808-1811 | 2014-06-23 |
| 1427312438 | Jesse Jeffrey Doll | Physician Assistant | 2360 Mullan Rd, Ste C, Missoula, MT 59808-1811 | 2012-06-25 |
| 1992016679 | Mike Kim Tran | Physical Therapist | 2360 Mullan Rd, Missoula, MT 59808-1811 | 2010-06-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447720875 | Megan Elizabeth Galliford | Behavioral Analyst | 1647 Shindig Dr, Apt 303, Missoula, MT 59808 | 2018-11-28 |
| 1518473560 | Willow Mahana Nelson Griffith | Registered Nurse | 2829 Great Northern Loop Ste 300, Missoula, MT 59808 | 2017-12-28 |
| 1043739428 | Carol Elizabeth Mckenzie | Student in an Organized Health Care Education/Training Program | 2705 Oshaughnessy St, Missoula, MT 59808 | 2017-09-16 |
| 1558884064 | Sharon Marie Herndon | Nurse Practitioner | 2230 N Reserve St Ste 402, Missoula, MT 59808 | 2017-07-18 |
| 1427594761 | Erin Boggs | Specialist/Technologist | 2921 Dublin St, Missoula, MT 59808 | 2017-01-10 |
| 1942603287 | Benjamin Cody Mcintosh | Chiropractor | 1070 N. Russell St., Missoula, MT 59808 | 2014-10-01 |
| 1518219617 | Pure Medical Inc | Ambulance | 5515 Bonanza Place, Missoula, MT 59808 | 2012-10-12 |
| 1932462231 | Kathleen F Calcagno | Specialist/Technologist | 2615 Connery Way, Suite 2b, Missoula, MT 59808 | 2012-06-21 |
| 1639454127 | Dentyn Dunaway | Pharmacist | 2527 N Reserve Street, Missoula, MT 59808 | 2011-10-15 |
| 1750557690 | Carl Thornblade, Md, Pllc | Allergy & Immunology | 2801 Great Northern Loop Ste 101, Missoula, MT 59808 | 2008-04-30 |
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| 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 |
|---|---|---|---|---|
| 1386262483 | Karly Niemann | Specialist/Technologist | Skaggs Bldg 32 Campus Dr, Missoula, MT 59812-0001 | 2020-07-06 |
| 1740815653 | Yuzo Fujiki | Specialist/Technologist | 210 N California St 104, Missoula, MT 59801 | 2020-03-11 |
| 1851938047 | Lynne Lorraine Roberts | Specialist/Technologist | 5105 Clearview Way, Missoula, MT 59803-2148 | 2019-12-06 |
| 1366004905 | Kayla Schmidt | Specialist/Technologist | 830 Crestmont Way Apt 101, Missoula, MT 59803-1510 | 2019-07-03 |
| 1285296947 | Luke Joseph Mccarthy | Specialist/Technologist | 737 Sun Pillar Loop Apt 2, Missoula, MT 59802-5433 | 2019-07-02 |
| 1639737877 | Nicholas Bradely Costa | Specialist/Technologist | 2240 Raymond Ave, Missoula, MT 59802-3512 | 2019-06-03 |
| 1316414212 | John Aaron Leske II | Specialist/Technologist | 2044 S 12th St W, Missoula, MT 59801-4816 | 2018-10-29 |
| 1679056634 | Samantha Graff | Specialist/Technologist | 1550 Milwaukee Way Apt 208, Missoula, MT 59801-3015 | 2018-09-14 |
| 1609353580 | Alicia Gene Williams | Specialist/Technologist | 1520 Ashberry Ct Apt 1, Missoula, MT 59801-8355 | 2018-07-24 |
| 1558847277 | Kayla Jode Farrell | Specialist/Technologist | 616 N 2nd St W, Missoula, MT 59802-2918 | 2018-07-16 |
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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.