KEN MACK (NPI# 1083926158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083926158 |
| Entity Type | Individual |
| Full Name | KEN MACK |
| Credential | PTA |
| Practice Address |
1005 N Hickory Rd South Bend IN 46615-3723 |
| Practice Telephone | 5742335754 |
| Practice Fax Number | 5742337406 |
| Mailing Telephone | 5742335754 |
| Mailing Fax Number | 5742337406 |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2010-07-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225200000X | Physical Therapy Assistant | 06003673 | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100351040 | 05 |
| Street Address |
1005 N HICKORY RD |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46615-3723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912903063 | Francis J Mcdonald | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-3723 | 2005-06-23 |
| 1023656907 | Lauren Taylor | Physical Therapy Assistant | 1005 N Hickory Rd, South Bend, IN 46615-2280 | 2019-12-11 |
| 1720567167 | Jeana Marie Marren | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-2280 | 2018-08-07 |
| 1285112771 | Christopher Higgins | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-2280 | 2018-08-06 |
| 1568974087 | Jonathan Cultura | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-3723 | 2017-10-25 |
| 1922457274 | Mary Stoller | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-3723 | 2016-06-08 |
| 1245630656 | Kaes Kamman | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-3723 | 2014-09-04 |
| 1013339167 | Nicholas Bugbee | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-3723 | 2014-01-08 |
| 1639421746 | Matthew Leblang | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-3723 | 2012-10-12 |
| 1346524063 | Neringa Snyder | Physical Therapy Assistant | 1005 N Hickory Rd, South Bend, IN 46615-3723 | 2011-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679954804 | Healthlinc, Inc. | Clinic/Center | 1002 S Esther St, South Bend, IN 46615 | 2015-06-12 |
| 1861897688 | Michelle Jean Streb | Registered Nurse | 1960 Northside Boulevard, South Bend, IN 46615 | 2014-10-23 |
| 1275848962 | Charles Mikel Craig | Optometrist | 220 N. Ironwood Dr., South Bend, IN 46615 | 2010-08-18 |
| 1710219613 | Debra Vasquez | Occupational Therapy Assistant | 1950 Ridgedaleroad, South Bend, IN 46615 | 2010-02-03 |
| 1114259132 | Christopher Joseph Smith | Physical Therapist | 1005 Hickory Rd, South Bend, IN 46615 | 2010-02-01 |
| 1295064525 | Starlight Care Facilities, Inc | Skilled Nursing Facility | 915 So. 27th Street, South Bend, IN 46615 | 2009-12-16 |
| 1699002642 | Ann G Pryor | Contractor | 1516 E. Wayne St., South Bend, IN 46615 | 2009-11-12 |
| 1891917449 | Logan Community Resources, Inc. | Community/Behavioral Health | 2505 E. Jefferson Blvd, South Bend, IN 46615 | 2007-05-03 |
| 1487712683 | Julie Gaydos Plagens | Dentist | 604 South Eddy St, South Bend, IN 46615 | 2006-12-04 |
| 1629163084 | Edward F Klodzinski | Counselor | 3603 E. Jefferson Blvd., South Bend, IN 46615 | 2006-10-03 |
| Find all providers in zip 46615 | ||||
| Taxonomy Code | 225200000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapy Assistant |
| (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of the physical therapist assistant. The PTA performs physical therapy procedures and related tasks that have been selected and delegated by the supervising physical therapist. Duties of the PTA include assisting the physical therapist in implementing treatment programs, training patients in exercised and activities of daily living, conducting treatments, and reporting to the physical therapist on the patient’s responses. In addition to direct patient care, the PTA may also perform such functions as patient transport, and clinic or equipment preparation and maintenance. Currently more than half of all states require PTAs to be licensed, registered or certified. (2) An individual who works under the supervision of a physical therapist to assist him or her in providing physical therapy services. A physical therapy assistant may, for instance, help patients follow an appropriate exercise program that will increase their strength, endurance, coordination, and range of motion and train patients to perform activities of daily life. |
| Notes: Source: (1) American Physical Therapy Association, P.O. Box 37257, Washington, D.C. 20013. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417568940 | Robin M Palisano-wolfe | Physical Therapy Assistant | 59808 Ironwood Rd, South Bend, IN 46614-9111 | 2020-08-10 |
| 1558843243 | Rachel Anne Adamyk | Physical Therapy Assistant | 1010 Robert Bush Drive West, South Bend, WA 98586 | 2018-08-30 |
| 1720455868 | Scott Berzai | Physical Therapy Assistant | 59220 Deer Run Ct, South Bend, IN 46614-4125 | 2015-08-24 |
| 1336521202 | Rachael Klowetter | Physical Therapy Assistant | 52565 State Road 933, South Bend, IN 46637-3257 | 2015-06-26 |
| 1679833438 | Whitney Moore | Physical Therapy Assistant | 2012 Ironwood Circle, Suite 230, Circle Centre Building, South Bend, IN 46635 | 2012-05-25 |
| 1265704019 | Daria Scott | Physical Therapy Assistant | 2401 Oakbrook Dr, South Bend, IN 46628-3495 | 2012-02-08 |
| 1336755180 | Judith Stayback | Physical Therapy Assistant | 53940 Carmichael Dr, South Bend, IN 46635-1564 | 2020-09-17 |
| 1972113496 | Jennifer Miller | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-10 |
| 1558971101 | Michelle Eichstedt | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-07 |
| 1316557390 | Kimberly Kinney | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-05 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46615 |
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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.