MR. KELLY SCOTT WITHEM (NPI# 1114342557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114342557 |
| Entity Type | Individual |
| Full Name | MR. KELLY SCOTT WITHEM |
| Credential | ATC, LAT |
| Practice Address |
1606 N 7th St Terre Haute IN 47804-2706 |
| Mailing Address |
150 N Rosenberger Ave Evansville IN 47712-6503 |
| Practice Telephone | 8122387000 |
| Mailing Telephone | 8124913856 |
| Mailing Fax Number | 8127591586 |
| Enumeration Date | 2014-02-21 |
| Last Update Date | 2014-02-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
36000257A | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1606 N 7TH ST |
| City | TERRE HAUTE |
| State | IN |
| Zip Code | 47804-2706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142587 | Mary A. Flynn | Specialist | 1606 N 7th St, Terre Haute, IN 47804-2706 | 2005-05-23 |
| 1851906622 | Patrick James Yoakum | Pharmacist | 1606 N 7th St, Terre Haute, IN 47804-2706 | 2020-09-09 |
| 1215546791 | Edra Burris | Radiology Practitioner Assistant | 1606 N 7th St, Terre Haute, IN 47804-2706 | 2020-07-30 |
| 1174132708 | Cep America - Neurology PC | Psychiatry & Neurology | 1606 N 7th St, Terre Haute, IN 47804-2706 | 2020-07-29 |
| 1114543352 | Megan Gale Engelman | Nurse Anesthetist, Certified Registered | 1606 N 7th St, Terre Haute, IN 47804-2706 | 2020-06-23 |
| 1518588706 | Chelsea Kizer | Nurse Practitioner | 1606 N 7th St, Terre Haute, IN 47804-2780 | 2020-04-29 |
| 1992334254 | Brock D Walker | Nurse Anesthetist, Certified Registered | 1606 N 7th St, Terre Haute, IN 47804-2706 | 2020-04-07 |
| 1528691433 | Brooke Michelle Llewellyn | Nurse Practitioner | 1606 N 7th St, Terre Haute, IN 47804-2706 | 2020-02-19 |
| 1922647205 | Jeanna Tabrizi | Nurse Practitioner | 1606 N 7th St, Terre Haute, IN 47804-2706 | 2020-01-03 |
| 1174171920 | Nicole Hranchook | Physical Therapist | 1606 N 7th St, Terre Haute, IN 47804-2706 | 2019-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568971885 | Tiffany Marshall | Physical Therapist | North At Uap Bone & Joint Center, Lower Level 1725 North 5th Street, Terre Haute, IN 47804 | 2017-09-29 |
| 1336565423 | Deondra Allison Cottrill | Physical Therapy Assistant | 1725 N. 5th Street, Union Hospital Therapy Services, Terre Haute, IN 47804 | 2014-03-13 |
| 1043635170 | Patricia Klos | Physical Therapy Assistant | 1606 Nth 7th Street, Terre Haute, IN 47804 | 2014-02-26 |
| 1043565476 | Debra Denehie Hills | Registered Nurse | 620 8th Avenue, Terre Haute, IN 47804 | 2012-07-23 |
| 1841503257 | Meredeth Su Gray | Dentist | 1608 Lafayette Avenue, Terre Haute, IN 47804 | 2010-07-15 |
| 1083946628 | John Barton, Lpt | Health Maintenance Organization | 1818 N 3rd Street, Terre Haute, IN 47804 | 2010-02-08 |
| 1750584009 | Kool Smiles In-3, PC | Dentist | 1800 Fort Harrison Rd, Terra Haute, IN 47804 | 2007-06-06 |
| 1619006988 | Union Hospital Inc | Student in an Organized Health Care Education/Training Program | 1513 N 6 1-2 Street, Terre Haute, IN 47804 | 2007-03-05 |
| 1730243080 | John Lee Nichols | Dentist | 1246 Maple Ave, Terre Haute, IN 47804 | 2006-12-21 |
| 1093894057 | Isaac N Mitre | Obstetrics & Gynecology | 1623 N 4th Street, Terre Haute, IN 47804 | 2006-11-02 |
| Find all providers in zip 47804 | ||||
| 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 |
|---|---|---|---|---|
| 1417421793 | Kimberly Ann White | Specialist/Technologist | 605 Oak Dr, Terre Haute, IN 47803-2337 | 2019-01-19 |
| 1104309624 | Jennifer E Meyer | Specialist/Technologist | 868 Champlain Ct Apt M, Terre Haute, IN 47803-4250 | 2018-09-11 |
| 1215435243 | Margaret Kyle | Specialist/Technologist | 6360 E Old Maple Ave, Terre Haute, IN 47803-9524 | 2018-01-24 |
| 1942711270 | Azumi Koyama | Specialist/Technologist | 1435 S Center St, Terre Haute, IN 47802-1121 | 2017-10-13 |
| 1699291658 | Shunnosuke Hayashi | Specialist/Technologist | 567 N 5th Street, Scwam 257, Terre Haute, IN 47809 | 2017-08-21 |
| 1174047880 | Ariane Alisabeth Clarissa Bell | Specialist/Technologist | 1206 S 18th Street, Terre Haute, IN 47803-4780 | 2017-08-03 |
| 1326578931 | Ian Nicholas Bostock | Specialist/Technologist | 1113 North 8th Street, Terre Haute, IN 47807 | 2017-06-15 |
| 1902336936 | Heather Lynn Pilch | Specialist/Technologist | 2225 Stone Creek Ln, Terre Haute, IN 47802-5438 | 2017-06-13 |
| 1568992592 | Jessica L Montoya | Specialist/Technologist | 6538 Allendale Blvd, Terre Haute, IN 47802-4794 | 2017-06-13 |
| 1770012866 | Taylor Rayl Smith | Specialist/Technologist | 1113 N 8th St, Terre Haute, IN 47807-1517 | 2017-06-12 |
| Find all providers in TERRE HAUTE | ||||
| City | TERRE HAUTE |
| Zip Code | 47804 |
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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.