MARK LAWRENCE HIBBARD (NPI# 1063920965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063920965 |
| Entity Type | Individual |
| Full Name | MARK LAWRENCE HIBBARD |
| Practice Address |
120 W Pearl Ave Jackson WY 83002 |
| Mailing Address |
Po Box 7791 Jackson WY 83002-7791 |
| Practice Telephone | 3077349129 |
| Mailing Telephone | 7607092122 |
| Enumeration Date | 2018-01-14 |
| Last Update Date | 2018-01-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669498499 | Mark E Hibbard | Anesthesiology | 3333 Riverbend Dr, Springfield, OR 97477-8800 | 2006-07-14 |
| Street Address |
120 W PEARL AVE |
| City | JACKSON |
| State | WY |
| Zip Code | 83002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285680041 | Maria E Lofgren | Physical Therapist | 120 W Pearl Ave, Jackson, WY 83001-8657 | 2006-05-25 |
| 1366008914 | Derrik Sulzer | Chiropractor | 120 W Pearl Ave, Jackson, WY 83001-8657 | 2019-05-18 |
| 1639621832 | Andi Gordon | Physical Therapist | 120 W Pearl Ave, Jackson, WY 83001-8657 | 2016-11-04 |
| 1609227362 | Gillian Butsch Berrian | Physical Therapist | 120 W Pearl Ave, Jackson, WY 83001-8657 | 2016-06-23 |
| 1073963286 | Sarah Niederbuhl | Physical Therapist | 120 W Pearl Ave, Jackson, WY 83001-8657 | 2016-06-18 |
| 1730563362 | Jessica J Kotnour | Physical Therapist | 120 W Pearl Ave, Jackson, WY 83001-8657 | 2015-07-14 |
| 1770985202 | Amy Jane Clemens | Acupuncturist | 120 W Pearl Ave, Jackson, WY 83001-8657 | 2014-09-16 |
| 1811329410 | Gianna Risoli | Physical Therapist | 120 W Pearl Ave, Jackson, WY 83001-8657 | 2013-08-06 |
| 1801235460 | Daniel R Mcaleese | Physical Therapist | 120 W Pearl Ave, Jackson, WY 83001-8657 | 2013-06-17 |
| 1043578214 | Kara T Jordan | Physical Therapist | 120 W Pearl Ave, Jackson, WY 83001-8657 | 2012-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659836336 | Casey Orzech | Registered Nurse | 4584 Fishing Club Drive, Jackson, WY 83002 | 2019-02-06 |
| 1093050510 | Irene Ann Nelson | Physician Assistant | 1490 Gregory Lane, Jackson, WY 83002 | 2012-12-10 |
| 1548590102 | Amy Pitman | Social Worker | 460 Cache Street, Jackson, WY 83002 | 2010-01-05 |
| 1669606943 | Canyon River Staffing | Nursing Care | 265 Blair Dr, Apt A, Jackson, WY 83002 | 2009-05-14 |
| 1477745842 | Catherine Haynes Wuthrich | Psychiatry & Neurology | 2092 Lilac Lane, Jackson, WY 83002 | 2007-08-09 |
| 1952518086 | Jennifer Agger Kandolin | Counselor | 420 South Jackson St., Jackson, WY 83002 | 2007-05-17 |
| 1992828503 | Ann M Fenn | Obstetrics & Gynecology | 62 Redmond St, Jackson, WY 83002 | 2007-04-09 |
| 1295863504 | Chad Roberts | Optometrist | 110 Buffalo Way, Ste A, Jackson, WY 83002 | 2007-02-28 |
| 1972645315 | Wyoming Eye Care Inc PC | Optometrist | 110 Buffalo Way St A, Jackson, WY 83002 | 2007-02-13 |
| 1386780237 | Charles F Harris | Physician Assistant | 982 W. Broadway, Jackson, WY 83002 | 2007-01-29 |
| Find all providers in zip 83002 | ||||
| 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 |
|---|---|---|---|---|
| 1205471752 | Shelly Ann Botwinick | Specialist/Technologist | 104 Daisy Ct, Jackson, NJ 08527-2582 | 2019-11-07 |
| 1023668019 | Jonathan Wilson | Specialist/Technologist | 1050 Union University Dr # 1811, Jackson, TN 38305-3656 | 2019-09-12 |
| 1588132161 | John Thomas Raybon | Specialist/Technologist | 328 Portis Ave, Jackson, AL 36545-2650 | 2018-11-13 |
| 1265925044 | Caroline Marie Stevens | Specialist/Technologist | 715 S Grinnell St, Jackson, MI 49203-1685 | 2018-06-07 |
| 1447762067 | Sarah Elisabeth Wilhelm | Specialist/Technologist | 3483 Spring Arbor Rd, Jackson, MI 49203-3637 | 2017-11-05 |
| 1619410388 | Erin Nelson | Specialist/Technologist | 4174 Lancashire Dr, Jackson, MI 49203-5137 | 2016-11-29 |
| 1235681685 | Latesha Fleming | Specialist/Technologist | 241 Glenside Dr, Jackson, MS 39211-4309 | 2016-11-02 |
| 1962855239 | David Miller | Specialist/Technologist | 917 Bellevue Pl, Jackson, MS 39202-2702 | 2016-07-21 |
| 1023488186 | Melanie J Weesies | Specialist/Technologist | 3417 Mayapple Ln Apt 32, Jackson, MI 49201-7199 | 2015-10-01 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| Find all providers in JACKSON | ||||
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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.