MRS. JENNIFER WALLY BLYSTONE (NPI# 1912147893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912147893 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER WALLY BLYSTONE |
| Other Name | MISS JENNIFER LYNN WALLY |
| Credential | ATC, EMT |
| Practice Address |
5140 White Oak Dr Indiana PA 15701-9479 |
| Practice Telephone | 7244639071 |
| Mailing Telephone | 7244639071 |
| Enumeration Date | 2009-03-04 |
| Last Update Date | 2009-03-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
RT001482A | PA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
5140 WHITE OAK DR |
| City | INDIANA |
| State | PA |
| Zip Code | 15701-9479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518508811 | Paula A. Smulik | Pharmacist | 280 Indian Springs Rd Ste 125, Indiana, PA 15701 | 2019-10-08 |
| 1588143713 | William Aden Bendgen IIi | Counselor | 470 N 4th Street, Indiana, PA 15701 | 2018-08-08 |
| 1699266452 | Shiela Ikasilon Otwane | Nurse Practitioner | 1 Regency Square, 1524 Oakland Avenue, Indiana, PA 15701 | 2018-05-28 |
| 1881184745 | Samantha Nichcol Bennett | Social Worker | 793 Old Rte 119 Hwy U, Indiana, PA 15701 | 2018-05-16 |
| 1780193896 | Abbey Mae Hill | Counselor | 793 Old Rotue 119 Hwy N, Indiana, PA 15701 | 2017-09-21 |
| 1568819456 | Karissa Wess Angleson | Physician Assistant | Indiana Regional Medical Center Emergency Department, 835 Hospital Rd, Indiana, PA 15701 | 2016-05-20 |
| 1588020721 | Forefront Dermatology, S.c. | Dermatology | 120 I.r.m.c. Drive, Suite 130, Indiana, PA 15701 | 2016-01-04 |
| 1881069201 | Amanda J Orvosh | Counselor | 1163 Water St, Indiana, PA 15701 | 2015-12-10 |
| 1245602887 | Susan Marie Marchezak | Nurse Practitioner | 2128 Oakland Avenue, Indiana, PA 15701 | 2015-10-22 |
| 1538546353 | Hillary Beth Stitt | Counselor | 793 Old Rt 119 Hwy N, Community Guidance Center, Indiana, PA 15701 | 2015-04-30 |
| Find all providers in zip 15701 | ||||
| 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 |
|---|---|---|---|---|
| 1518595586 | Evan Schreyer | Specialist/Technologist | 660 S 11th Street, Indiana, PA 15705-0001 | 2020-03-27 |
| 1174181887 | Derek Stapleton | Specialist/Technologist | 132 N 9th St, Indiana, PA 15701-1713 | 2019-05-29 |
| 1811415862 | Allison Gwen Hill | Specialist/Technologist | 1090 South Dr, Indiana, PA 15705-1038 | 2017-08-30 |
| 1285152231 | Megan Nicole Coyne | Specialist/Technologist | 1090 South Dr., Indiana, PA 10705 | 2017-08-30 |
| 1164940110 | Tyler J Bradley | Specialist/Technologist | 1090 South Drive, Indiana, PA 15701-1570 | 2017-08-30 |
| 1033529003 | Frank Trenney | Specialist/Technologist | 660 S 11th St, Indiana, PA 15705-1030 | 2014-04-30 |
| 1033102421 | James Joseph Racchini | Specialist/Technologist | Memorial Field House, Indiana University of Pennsylvania, Indiana, PA 15705-0001 | 2005-08-31 |
| 1699293589 | Ashley Smith | Specialist/Technologist | 660 S 11th St, Indiana, PA 15705-1030 | 2017-08-31 |
| 1184142135 | Lucas Dalton Weltz Sr. | Specialist/Technologist | 1090 South Dr, Indiana, PA 15705-1038 | 2017-08-30 |
| 1447778493 | Katelyn Noel Cerutti | Specialist/Technologist | 1090 South Dr, Indiana, PA 15705-1038 | 2017-08-30 |
| Find all providers in INDIANA | ||||
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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.