MALLORY FAIVRE (NPI# 1093360588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093360588 |
| Entity Type | Individual |
| Full Name | MALLORY FAIVRE |
| Credential | ATC |
| Practice Address |
410 1st St Kirkland IL 60146-7700 |
| Practice Telephone | 8155222697 |
| Practice Fax Number | 8155229918 |
| Mailing Telephone | 8155222697 |
| Mailing Fax Number | 8155229918 |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2019-08-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
096003874 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
410 1ST ST |
| City | KIRKLAND |
| State | IL |
| Zip Code | 60146-7700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912472267 | Michelle Platt | Psychologist | 410 1st St, Kirkland, IL 60146-7700 | 2018-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619285509 | Simple Rx Inc. | Pharmacy | 527 West Main St. Unit 1w, Unit 1w, Kirkland, IL 60146 | 2010-09-14 |
| 1821265588 | Robert Tutt | Community Health Worker | 5610 Hortense, Kirkland, IL 60146 | 2008-05-13 |
| 1114947876 | Thomas L. Michalsen | General Practice | 406 South 5th Street, Kirkland, IL 60146 | 2006-07-19 |
| 1598783037 | Barbara J Runne | Dentist | 105 Brennan Drive, Kirkland, IL 60146 | 2006-07-17 |
| 1831363076 | Barbara J. Runne, D.d.s. | Dentist | 105 Brennan Drive, Kirkland, IL 60146 | 2008-04-18 |
| 1841214368 | Thomas L. Michalsen Do Ltd | Family Medicine | 406 South 5th Street, Kirkland, IL 60146 | 2006-07-27 |
| 1477755981 | Hiawatha Cusd 426 | Local Education Agency (LEA) | First Hortense, Kirkland, IL 60146-0428 | 2007-06-05 |
| 1154877934 | Cynthia Anderson | Social Worker | 409 Lawrence Drive, Kirkland, IL 60146-0433 | 2016-08-31 |
| 1225431653 | Cathy Carlson | Nurse Practitioner | 406 S 5th St, Kirkland, IL 60146-7711 | 2014-09-30 |
| 1316418387 | Katelyn Bruch | Nurse Practitioner | 34650 Bucks Rd, Kirkland, IL 60146-8342 | 2018-12-16 |
| Find all providers in zip 60146 | ||||
| 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 |
|---|---|---|---|---|
| 1760929020 | Tamara Smallman | Specialist/Technologist | 12515 Ne 80th Pl, Kirkland, WA 98033-8055 | 2017-01-25 |
| 1962778134 | Jamie L Miller | Specialist/Technologist | 5520 108th Ave Ne, Kirkland, WA 98033-7523 | 2012-03-31 |
| 1922304773 | Robert Diehl | Specialist/Technologist | 10601 Ne 132nd St, Kirkland, WA 98034-2824 | 2011-01-26 |
| 1114249331 | Dayna J Hall | Specialist/Technologist | 12131 Ne 107th St, Kirkland, WA 98033-4676 | 2010-02-16 |
| 1861645996 | Clayton Delaney Farmer | Specialist/Technologist | 12609 Ne 132nd St, Unit B, Kirkland, WA 98034-3139 | 2008-11-03 |
| 1508064163 | Phillip James Varney | Specialist/Technologist | 14326 124th Ave Ne, Kirkland, WA 98034 | 2007-07-05 |
| 1528184819 | Sam Ramsden | Specialist/Technologist | 11220 Ne 53rd St, Kirkland, WA 98033-7505 | 2007-03-21 |
| 1205963147 | Donald M Rich IIi | Specialist/Technologist | 10724 Slater Ave Ne, Kirkland, WA 98033-4607 | 2007-02-27 |
| 1437296241 | Anne Janette Taylor | Specialist/Technologist | 11135 Ne 128th St Apt H101, Kirkland, WA 98034-4783 | 2007-01-31 |
| 1073514519 | Martin Matney | Specialist/Technologist | 13120 Ne 70th Pl, Suite 3, Kirkland, WA 98033-8570 | 2005-08-09 |
| Find all providers in KIRKLAND | ||||
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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.