QUINTON JARRETT PETERS (NPI# 1144703653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144703653 |
| Entity Type | Individual |
| Full Name | QUINTON JARRETT PETERS |
| Credential | ATC, LAT, EMT-B |
| Practice Address |
1204 S Jefferson St Appleton WI 54915-1726 |
| Practice Telephone | 7154981996 |
| Mailing Telephone | 7154981996 |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2019-12-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
70107210 | WI | Allopathic & Osteopathic Physicians |
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2261-39 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1204 S JEFFERSON ST |
| City | APPLETON |
| State | WI |
| Zip Code | 54915-1726 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205466737 | Leyes Robers Dental LLC | Dentist | 3216 W County Rd Kk, Appleton, WI 54915 | 2020-01-23 |
| 1912426958 | Shanna L. Larsen | Registered Nurse | 1101 E. South River St., Appleton, WI 54915 | 2017-09-11 |
| 1477082816 | Amy Fazel | Driver | 226 E Calumet St, Appleton, WI 54915 | 2017-06-08 |
| 1871940213 | B.a.israel LLC | Community Based Residential Treatment Facility, Mental Illness | N9520 Silver Court, Appleton, WI 54915 | 2016-05-16 |
| 1982933479 | Stephanie I. Braski | Counselor | 1531 S. Oneida St, Appleton, WI 54915 | 2009-12-14 |
| 1386808319 | Shawn S Williamson | Emergency Medicine | 1506 South Oneida Street, Appleton, WI 54915 | 2008-07-18 |
| 1700040870 | Heidi Jo Van Toll | Occupational Therapist | 1335 S Oneida Street, Appleton, WI 54915 | 2008-07-17 |
| 1669639142 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | N9642 County Rd N, Appleton, WI 54915 | 2008-05-21 |
| 1265699748 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1531 S Madison St Fl 4, Appleton, WI 54915 | 2008-05-21 |
| 1073770558 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1531 S Madison St Ste 580, Appleton, WI 54915 | 2008-05-21 |
| Find all providers in zip 54915 | ||||
| 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 |
|---|---|---|---|---|
| 1427657329 | Tyler John Friis | Specialist/Technologist | 1514 E Keystone Ln, Appleton, WI 54913-7162 | 2020-10-21 |
| 1982252631 | Lorrie Ann Formella | Specialist/Technologist | 604 N Richmond St, Appleton, WI 54911-4659 | 2019-08-27 |
| 1700448933 | Cassandra Timmers | Specialist/Technologist | 5000 North Ballard Road, Appleton, WI 54913-5491 | 2019-07-09 |
| 1407411051 | Connor Larson | Specialist/Technologist | 2244 W Capitol Dr, Appleton, WI 54914-6828 | 2019-05-08 |
| 1609332303 | Hudson Bernard Kopp | Specialist/Technologist | 3601 N Marcos Ln, Appleton, WI 54911-8465 | 2019-02-18 |
| 1073084034 | Adam Larsen | Specialist/Technologist | 3117 E Drake Ln, Appleton, WI 54913-8000 | 2018-12-16 |
| 1871083527 | Mason Harold Schnese | Specialist/Technologist | W5625 Vans Rd, Appleton, WI 54915-9313 | 2018-05-17 |
| 1316311905 | Lucy Bouressa | Specialist/Technologist | 2105 E. Enterprise Ave, 113, Appleton, WI 54913 | 2015-11-19 |
| 1407225949 | Joshua Sanders | Specialist/Technologist | 618 W Seymour St, Appleton, WI 54915-1249 | 2015-09-15 |
| 1134597610 | Stuart Burkart | Specialist/Technologist | 610 N Badger Ave, Appleton, WI 54914-3405 | 2015-09-14 |
| Find all providers in APPLETON | ||||
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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.