MARISELA MAGDALENA MEDINA (NPI# 1891317319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891317319 |
| Entity Type | Individual |
| Full Name | MARISELA MAGDALENA MEDINA |
| Practice Address |
1595 S Calumet Rd Ste 3 Chesterton IN 46304-2389 |
| Mailing Address |
323 W Division Rd Valparaiso IN 46385-9049 |
| Practice Telephone | 2197644888 |
| Practice Fax Number | 2198984258 |
| Mailing Telephone | 2195088297 |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2020-05-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200196020A | 05 |
| Street Address |
1595 S CALUMET RD STE 3 |
| City | CHESTERTON |
| State | IN |
| Zip Code | 46304-2389 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326203076 | Nadiyah Dickerson | Speech-Language Pathologist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2008-07-22 |
| 1801400809 | Morgan Taylor Laux | Physical Therapist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2020-09-07 |
| 1750907937 | Kourtney New | Speech-Language Pathologist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2020-06-23 |
| 1518502491 | Brandi Nicole York | Developmental Therapist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2019-11-14 |
| 1659927887 | Katie Dewind | Speech-Language Pathologist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2019-08-13 |
| 1851947428 | Stacia Oconnor | Occupational Therapy Assistant | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2019-08-09 |
| 1376199901 | Rylie Shrum | Speech-Language Pathologist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2019-08-09 |
| 1184285835 | Lucille Ann Newton | Developmental Therapist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2019-06-24 |
| 1962062554 | Hayley Olivia Gust | Developmental Therapist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2019-06-17 |
| 1598323693 | Marlee Y Mcgrath | Developmental Therapist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2019-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184274268 | Trinity Healthcare Inc. | Occupational Therapist | 2300 Village Point, Chesterton, IN 46304 | 2019-09-19 |
| 1962987206 | Kara Polus | Physical Therapy Assistant | 1595 S Calumet Rd Suite 3, Chesterton, IN 46304 | 2018-10-02 |
| 1275024481 | Karson Rice | Developmental Therapist | 1595 S Calumet Rd, Suite 3, Chesterton, IN 46304 | 2018-05-23 |
| 1720527765 | Alina Broski I | Occupational Therapy Assistant | 1120 S. Calument Road, Suite 3, Chesterton, IN 46304 | 2017-02-22 |
| 1538612015 | Muhammad Ziad Souqiyyeh | Internal Medicine | 3100 Village Pt Ste 102, Chesterton, IN 46304 | 2016-08-01 |
| 1942671656 | Samantha Stremich | Psychologist | 1496 Pope Ct # 2, Chesterton, MI 46304 | 2015-10-08 |
| 1669852299 | Deborah Joan Krause | Physical Therapy Assistant | 780 Dickinson Rd., Addison Pointe Health & Rehab Center, Chesterton, IN 46304 | 2015-06-09 |
| 1538462338 | Sunil Patel Md. P.C. | Internal Medicine | 1140 S. Calumet Road, Suite #2, Chesterton, IN 46304 | 2010-12-16 |
| 1629301981 | Lindsay Allison Munden | Nurse Practitioner | 505 County Road 1100 North, Chesterton, IN 46304 | 2009-09-17 |
| 1881851509 | Total Renal Care Inc | Clinic/Center | 711 Plaza Dr, Ste 6, Chesterton, IN 46304 | 2008-05-20 |
| Find all providers in zip 46304 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275024481 | Karson Rice | Developmental Therapist | 1595 S Calumet Rd, Suite 3, Chesterton, IN 46304 | 2018-05-23 |
| 1497877617 | Jennifer Gray | Developmental Therapist | 414 E Burdick Rd, Chesterton, IN 46304-9527 | 2007-04-06 |
| 1518502491 | Brandi Nicole York | Developmental Therapist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2019-11-14 |
| 1184285835 | Lucille Ann Newton | Developmental Therapist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2019-06-24 |
| 1962062554 | Hayley Olivia Gust | Developmental Therapist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2019-06-17 |
| 1598323693 | Marlee Y Mcgrath | Developmental Therapist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2019-06-03 |
| 1982260881 | Anja Vezmar | Developmental Therapist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2019-05-15 |
| 1043874597 | Sonja Vasic | Developmental Therapist | 1595 S Calumet Rd, Chesterton, IN 46304-2388 | 2019-04-30 |
| 1487218111 | Susan Louise Matejczyk | Developmental Therapist | 1120 S Calumet Rd Ste 3, Chesterton, IN 46304-3286 | 2019-04-29 |
| 1003379058 | Ashley Catherine Matthews | Developmental Therapist | 1595 S Calumet Rd Ste 3, Chesterton, IN 46304-2389 | 2019-04-08 |
| Find all providers in CHESTERTON | ||||
| City | CHESTERTON |
| Zip Code | 46304 |
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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.