MISS NICOLETTE JULIANNE CARSILLO (NPI# 1104362359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104362359 |
Entity Type | Individual |
Full Name | MISS NICOLETTE JULIANNE CARSILLO |
Credential | LAT, ATC |
Practice Address |
3527 N Valdosta Rd Valdosta GA 31602-6418 |
Practice Telephone | 2292472290 |
Practice Fax Number | 2292479627 |
Mailing Telephone | 2292472290 |
Mailing Fax Number | 2292479627 |
Enumeration Date | 2017-01-12 |
Last Update Date | 2017-01-12 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT002863 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Street Address |
3527 N VALDOSTA RD |
City | VALDOSTA |
State | GA |
Zip Code | 31602-6418 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083618052 | Charles W Sanderlin Jr. | Orthopaedic Surgery | 3527 N Valdosta Rd, Valdosta, GA 31602-1068 | 2005-06-08 |
1962030809 | Leah Michelle Bagley | Nurse Practitioner | 3527 N Valdosta Rd, Valdosta, GA 31602-6418 | 2020-03-27 |
1700418514 | Caitlyn Christine Register | Nurse Practitioner | 3527 N Valdosta Rd, Valdosta, GA 31602-6418 | 2020-02-10 |
1720633803 | Andrew Taylor | Physical Therapist | 3527 N Valdosta Rd, Valdosta, GA 31602-6418 | 2019-08-06 |
1033675467 | Ashly Mcdaniel | Physician Assistant | 3527 N Valdosta Rd, Valdosta, GA 31602-6418 | 2019-02-11 |
1649710708 | Lindsay Scarpate | Marriage & Family Therapist | 3527 N Valdosta Rd, Valdosta, GA 31602-6418 | 2017-03-08 |
1710423348 | Nicholas Adam Howard | Specialist/Technologist | 3527 N Valdosta Rd, Valdosta, GA 31602-6418 | 2017-01-06 |
1891035663 | David Sean Hermansen | Physician Assistant | 3527 N Valdosta Rd, Valdosta, GA 31602-6418 | 2013-02-15 |
1841452505 | Michael Allen Clark | Orthopaedic Surgery | 3527 N Valdosta Rd, Valdosta, GA 31602-6418 | 2008-06-25 |
1124280862 | Paul Dolphous Lane Jr. | Orthopaedic Surgery | 3527 N Valdosta Rd, Valdosta, GA 31602-6418 | 2008-06-25 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
Find all providers in zip 31602 |
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 |
---|---|---|---|---|
1508484718 | Mckenna Kristine Bachmann | Specialist/Technologist | Moody Air Force Base, Valdosta, GA 31605 | 2020-07-14 |
1851939797 | Chelsea Carter | Specialist/Technologist | 1300 Melody Ln Apt D14, Valdosta, GA 31601-7592 | 2019-12-10 |
1912544081 | Derykah Yates | Specialist/Technologist | 4318 Brandonshire Ln, Valdosta, GA 31605-7010 | 2019-12-07 |
1902443534 | Nicholas Thomas Hamilton | Specialist/Technologist | 805 Harmon Dr Apt C2, Valdosta, GA 31601-3603 | 2019-12-02 |
1437700838 | Tristan Carlos Garcia | Specialist/Technologist | 605 West Mary Street, Valdosta, GA 31601 | 2019-09-26 |
1780147421 | Claire Nicole Siceloff | Specialist/Technologist | 2092 S Sherwood Dr Apt 121, Valdosta, GA 31602-2249 | 2019-04-10 |
1962968925 | Olivia Spuler | Specialist/Technologist | 1500 North Ashley St, Valdosta, GA 31698-8828 | 2019-02-14 |
1528540804 | Alexander Stephen Cosper | Specialist/Technologist | 816 Valerie Pl, Valdosta, GA 31605-6426 | 2018-09-03 |
1063911295 | Chelsea Tatiyana Mayo | Specialist/Technologist | 1601 Norman Dr Apt Jj8, Valdosta, GA 31601-3247 | 2018-02-02 |
1073025961 | Maci Dee Fox | Specialist/Technologist | 605 W Mary Street, Valdosta, GA 31698-0001 | 2017-10-31 |
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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.