MAISIE BOEHM (NPI# 1851928329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851928329 |
| Entity Type | Individual |
| Full Name | MAISIE BOEHM |
| Credential | LAT |
| Practice Address |
700 Geneva Pkwy N Lake Geneva WI 53147-4594 |
| Practice Telephone | 2622493529 |
| Practice Fax Number | 2622497955 |
| Mailing Telephone | 2622493529 |
| Mailing Fax Number | 2622497955 |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2020-03-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
700 GENEVA PKWY N |
| City | LAKE GENEVA |
| State | WI |
| Zip Code | 53147-4594 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134217763 | Tara M. Grocholski | Physical Therapist | 700 Geneva Pkwy N, Lake Geneva, WI 53147-4594 | 2006-10-10 |
| 1134748916 | Breanna Johnson | Physical Therapy Assistant | 700 Geneva Pkwy N, Lake Geneva, WI 53147-4594 | 2020-04-13 |
| 1053948216 | Beulah Suzanne Carpenter | Massage Therapist | 700 Geneva Pkwy N, Lake Geneva, WI 53147-4594 | 2020-03-26 |
| 1639734999 | Lauren Lange | Occupational Therapist | 700 Geneva Pkwy N, Lake Geneva, WI 53147-4594 | 2019-05-02 |
| 1598290678 | Ellen Block | Occupational Therapist | 700 Geneva Pkwy N, Lake Geneva, WI 53147-4594 | 2017-04-26 |
| 1902355795 | Krista M Lamb | Physical Therapist | 700 Geneva Pkwy N, Lake Geneva, WI 53147-4594 | 2016-09-22 |
| 1003363599 | Erin E Mahoney | Physical Therapist | 700 Geneva Pkwy N, Lake Geneva, WI 53147-4594 | 2016-09-01 |
| 1841699600 | Sara Bader | Specialist/Technologist | 700 Geneva Pkwy N, Lake Geneva, WI 53147-4594 | 2014-08-18 |
| 1316202658 | Megan Rose Walsh | Speech-Language Pathologist | 700 Geneva Pkwy N, Lake Geneva, WI 53147-4594 | 2012-07-12 |
| 1306065404 | James Chapman | Physical Therapist | 700 Geneva Pkwy N, Lake Geneva, WI 53147-4594 | 2007-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356951206 | Emily Tanis | Physical Therapist | 6722 Wi-50, Lake Geneva, WI 53147 | 2020-08-05 |
| 1588295653 | Baylee M Noe | Occupational Therapy Assistant | Sage Meadow of Lake Geneva 6722 Wi-50, Lake Geneva, WI 53147 | 2020-01-28 |
| 1124539556 | Roxanne Weber | Registered Nurse | 146 E. Geneva Square, Lake Geneva, WI 53147 | 2017-10-12 |
| 1386969400 | Emily Kathleen Wilczak | Surgery | N2950 Wi-67, Lake Geneva, WI 53147 | 2010-03-31 |
| 1538294020 | Dale Alan Miller | Pharmacist | 2950 St. Hwy. 67, Lake Geneva, WI 53147 | 2007-02-23 |
| 1689779902 | Balistreri & Associates Physical Therapy | Physical Therapist | 902 Wells Street, Lake Geneva, WI 53147 | 2006-09-13 |
| 1336157981 | Nestor C Alabarca | Internal Medicine | 146 E Geneva Square, Lake Geneva, WI 53147 | 2006-08-03 |
| 1144259375 | Kim M. Cuculi | Occupational Therapist | 800 Geneva Pkwy N Ste 3, Lake Geneva, WI 53147 | 2006-07-01 |
| 1396253571 | Amar Y. Patel | Family Medicine | 146 E Geneva Sq, Lake Geneva, WI 53147 | 2018-01-22 |
| 1679017925 | Christina L. Clancy | Nurse Practitioner | 146 E Geneva Sq, Lake Geneva, WI 53147 | 2016-12-06 |
| Find all providers in zip 53147 | ||||
| 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 |
|---|---|---|---|---|
| 1841699600 | Sara Bader | Specialist/Technologist | 700 Geneva Pkwy N, Lake Geneva, WI 53147-4594 | 2014-08-18 |
| 1578904223 | Amanda Kutis | Specialist/Technologist | 146 E Geneva Sq, Lake Geneva, WI 53147-9694 | 2013-07-10 |
| 1386812105 | Ryan P Romeo | Specialist/Technologist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2008-02-14 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | LAKE GENEVA |
| Zip Code | 53147 |
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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.