SHELLY MICKENS (NPI# 1134467780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134467780 |
| Entity Type | Individual |
| Full Name | SHELLY MICKENS |
| Credential | MS, ATC, CSCS |
| Practice Address |
4101 Cox Rd Ste 301 Glen Allen VA 23060-3320 |
| Practice Telephone | 8042707750 |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2013-01-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
0126000235 | VA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
4101 COX RD STE 301 |
| City | GLEN ALLEN |
| State | VA |
| Zip Code | 23060-3320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356441745 | Linda M Bugbee | Psychiatry & Neurology | 4101 Cox Rd, Suite 340, Glen Allen, VA 23060 | 2006-09-25 |
| 1457789737 | Philamena Marie Cowan | Occupational Therapist | 4101 Cox Rd, Glen Allen, VA 23060-3320 | 2013-10-23 |
| 1114295011 | Patricia L. Buisset | Occupational Therapy Assistant | 4101 Cox Rd, 325, Glen Allen, VA 23060-3320 | 2011-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205469715 | Romy Sharieff | Midwife | 10433 Mountain Glen Pkwy, Glen Allen, VA 23060 | 2020-02-13 |
| 1366934549 | Guillermo Del Campo | Optometrist | 4114 Innslake Drive, Glen Allen, VA 23060 | 2018-06-04 |
| 1871013771 | Wecare Medical Transportation Inc. | Driver | 10524 Boscastle Rd, Glen Allen, VA 23060 | 2017-06-21 |
| 1265889570 | Darchelle Braxton Dmd PC | Dentist | 4300 Pouncey Tract Road Suite I, Glen Allen, VA 23060 | 2016-05-17 |
| 1952714842 | Gaynier Orthodontics PC | Clinic/Center | 4701 Cox Rx Ste 285, C/o Ct Corporation, Glen Allen, VA 23060 | 2014-06-09 |
| 1538507819 | Rca Laboratory Services, LLC | Clinical Medical Laboratory | 4060 Innslake Dr, Glen Allen, VA 23060 | 2013-06-10 |
| 1922352772 | Samantha S Stone | Physical Therapist | 4101 Cox Rd Ste 100, Glen Allen, VA 23060 | 2012-11-01 |
| 1609123660 | Stephanie Rene Matsko | Optometrist | 4114 Innslake Dr., Glen Allen, VA 23060 | 2012-08-09 |
| 1851661367 | Lateaka Sheri Vinson | Speech-Language Pathologist | 2250 Old Brick Rd, Suite 2229, Glen Allen, VA 23060 | 2012-01-01 |
| 1568774271 | Cynthia A Koza | Optometrist | 4600 Cox Road, Suite 120, Glen Allen, VA 23060 | 2010-07-10 |
| Find all providers in zip 23060 | ||||
| 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 |
|---|---|---|---|---|
| 1033638440 | Caroline Taylor | Specialist/Technologist | 5143 Dorin Hill Ct., Glen Allen, VA 23059 | 2017-09-18 |
| 1891137063 | Sari Cattoni | Specialist/Technologist | 10700 Staples Mill Rd, Glen Allen, VA 23060-2403 | 2013-07-29 |
| 1669905667 | Tanner Ryan Howell | Specialist/Technologist | 10700 Staples Mill Rd, Glen Allen, VA 23060-2403 | 2017-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295335487 | Sukyoon Chang | Specialist/Technologist | 6001 Grove Ave, Richmond, VA 23226-2603 | 2020-10-28 |
| 1912507302 | Madeline Joanna Bills | Specialist/Technologist | 308 Locust Grove Dr, Purcellville, VA 20132-3391 | 2020-10-27 |
| 1679171193 | Camden Oakes Bentley | Specialist/Technologist | 634 Treys Dr, Winchester, VA 22601-3230 | 2020-10-16 |
| 1932707437 | Madison Dobscha | Specialist/Technologist | 1706 Revere Ct Ne, Leesburg, VA 20176-6634 | 2020-10-15 |
| 1710584792 | Melvin Enderes | Specialist/Technologist | 42678 Frontier Dr, Brambleton, VA 20148-7207 | 2020-10-02 |
| 1285249755 | Amy Virostek | Specialist/Technologist | 1015 Heathercroft Cir Ste 200, Crozet, VA 22932-3370 | 2020-09-11 |
| 1255942264 | Xavier Thompson | Specialist/Technologist | 210 Emmet St S Rm 222, Charlottesville, VA 22903-2455 | 2020-08-13 |
| 1225647969 | Madison Polk | Specialist/Technologist | 9229 Arnie Ct, Manassas Park, VA 20111-3071 | 2020-07-29 |
| 1760090955 | Alymaris O'reilly | Specialist/Technologist | 5211 Duncan Trl, Reva, VA 22735-2016 | 2020-07-14 |
| 1740808377 | Aimee Gardanier | Specialist/Technologist | 2526 24th St N Lowr Unit, Arlington, VA 22207-4907 | 2020-07-09 |
| Find all providers with the same taxonomy | ||||
| City | GLEN ALLEN |
| Zip Code | 23060 |
Please comment or provide details below to improve the information on SHELLY MICKENS.
| 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.