MR. BENJAMIN M WILLY (NPI# 1164854303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164854303 |
| Entity Type | Individual |
| Full Name | MR. BENJAMIN M WILLY |
| Credential | ATC |
| Practice Address |
4150 Main St Jasper TN 37347-3445 |
| Mailing Address |
8823 Production Ln Ooltewah TN 37363-6511 |
| Practice Telephone | 4239428073 |
| Practice Fax Number | 4239426660 |
| Mailing Telephone | 4232387217 |
| Mailing Fax Number | 4232383473 |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2016-05-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2056 | TN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT 558 | AR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
4150 MAIN ST |
| City | JASPER |
| State | TN |
| Zip Code | 37347-3445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629518626 | Mary Elisabeth Jordan | Clinical Nurse Specialist | 4665 Main St Suite 2, Jasper, TN 37347 | 2017-02-24 |
| 1336569359 | Kevin Stevens | Emergency Medicine | 1000 Tn-28, Jasper, TN 37347 | 2014-04-17 |
| 1487801924 | Valley Imaging Partners, P.C. | Radiology | 1000 Hwy 28, Jasper, TN 37347 | 2008-08-27 |
| 1053494708 | Elizabeth Rodgers | Nurse Practitioner | 215 Hickman Road, Jasper, TN 37347 | 2006-10-23 |
| 1386726875 | Wal-mart Stores East, Lp | Technician/Technologist | 525 Kimball Crossing, Kimball, TN 37347 | 2006-10-20 |
| 1427033307 | Karim D Hasnani | Dentist | 507 Betsy Pack Dr Suite B, Jasper, TN 37347 | 2005-12-13 |
| 1932184017 | Craig John Cott | Psychiatry & Neurology | 215 Hickman Rd, Jasper, TN 37347 | 2005-12-12 |
| 1104817774 | Karin B Boeck | Family Medicine | 24 Mountain View Drive, Suite A, Kimball, TN 37347 | 2005-11-02 |
| 1508344227 | Faith Hannah Williams | Registered Nurse | 1000 Tn-28, Jasper, TN 37347 | 2018-08-03 |
| 1861752578 | Jana Marlow | Social Worker | 215 Hickman Rd, Jasper, TN 37347 | 2012-05-29 |
| Find all providers in zip 37347 | ||||
| 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 |
|---|---|---|---|---|
| 1235753278 | Lauren Schnell | Specialist/Technologist | 3196 Lakeside Dr, Jasper, IN 47546-9517 | 2020-06-05 |
| 1033683222 | Jessica Leigh Carter | Specialist/Technologist | 5580 Nw Us Highway 41, Jasper, FL 32052-6423 | 2019-01-22 |
| 1295198968 | Daniel Rogers | Specialist/Technologist | 600 W 13th St Ste 200, Jasper, IN 47546-1883 | 2016-03-31 |
| 1487044095 | Kathryn Cleek | Specialist/Technologist | 5483 N Portersville Rd, Jasper, IN 47546-9639 | 2015-02-03 |
| 1366862211 | Joseph Guthrie Jr. | Specialist/Technologist | 400 Bulldog Ave, Jasper, TX 75951-4954 | 2014-04-18 |
| 1366804171 | Tiffani Ubelhor | Specialist/Technologist | 600 W 13th St, Suite 200, Jasper, IN 47546-1881 | 2016-03-22 |
| 1205896990 | Robert Wade White | Specialist/Technologist | 2980 Highway 78 E, Jasper, AL 35501-8903 | 2006-03-25 |
| 1710947411 | Tara Michelle Howell | Specialist/Technologist | 2980 Highway 78 E, Jasper, AL 35501-8903 | 2006-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124628979 | Casey Brooks | Specialist/Technologist | 1223 Huntsville Hwy, Fayetteville, TN 37334-3617 | 2020-10-30 |
| 1275147761 | Samantha Michelle Howell | Specialist/Technologist | 1551 Lake Loudon Blvd Ofc A111, Knoxville, TN 37916-4009 | 2020-09-02 |
| 1447869391 | Kurt Howard Robbins | Specialist/Technologist | 7855 Racquetball Ln Apt 317, Cordova, TN 38016-8629 | 2020-07-27 |
| 1285242529 | Kelley Anne Seekins | Specialist/Technologist | 204 E. College St., Athens, TN 37303 | 2020-07-22 |
| 1437776143 | Kayla Hayes | Specialist/Technologist | 305 W Bell Ave, Chattanooga, TN 37405-3401 | 2020-06-29 |
| 1952928673 | Ashton Bailey Sexton | Specialist/Technologist | 622 Steekee St, Loudon, TN 37774-1167 | 2020-06-29 |
| 1710504303 | David Spencer Hiland | Specialist/Technologist | 150 Jake Branch Rd, Beechgrove, TN 37018-3177 | 2020-06-29 |
| 1659998367 | Kristopher Ace Ippolito | Specialist/Technologist | 212 Walnut St Apt 254, Chattanooga, TN 37403-4400 | 2020-06-29 |
| 1316564032 | Zachary Peter Brown | Specialist/Technologist | 24 Mountain Orchard Path, Signal Mountain, TN 37377-2663 | 2020-06-29 |
| 1518584218 | Christopher Zane Slater | Specialist/Technologist | 1915 Miller Crossroads Rd, Hillsboro, TN 37342-3720 | 2020-06-29 |
| Find all providers with the same taxonomy | ||||
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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.