MRS. BETHANY ALTA SHAW (NPI# 1225003684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225003684 |
| Entity Type | Individual |
| Full Name | MRS. BETHANY ALTA SHAW |
| Credential | ATC, LAT |
| Practice Address |
2025 E Newport Ave Milwaukee WI 53211-2906 |
| Mailing Address |
1720 E Capitol Dr #212 Shorewood WI 53211-1951 |
| Practice Telephone | 4149614666 |
| Mailing Telephone | 4142346130 |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
693-039 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154489276 | Bethany Ann Shaw | Psychologist | 167 S State St, Suite 100, Westerville, OH 43081-2265 | 2006-12-04 |
| Street Address |
2025 E NEWPORT AVE |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53211-2906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972585529 | James Sherry | Specialist | 2025 E Newport Ave, Milwaukee, WI 53211-2906 | 2005-11-18 |
| 1255644506 | Anne Catherine Melvin | Physician Assistant | 2025 E Newport Ave, S217, Milwaukee, WI 53211-2906 | 2010-07-15 |
| 1952636946 | Emily Markowski | Physical Therapist | 2025 E Newport Ave, Milwaukee, WI 53211-2906 | 2009-10-08 |
| 1841428612 | Mindy Stollenwerk | Physical Therapist | 2025 E Newport Ave, Milwaukee, WI 53211-2906 | 2009-06-30 |
| 1467680959 | Maureen Foley Nuechterlein | Dietitian, Registered | 2025 E Newport Ave, Milwaukee, WI 53211-2906 | 2009-06-23 |
| 1578798930 | Timothy E Mcelroy | Counselor | 2025 E Newport Ave, Suite 404, Milwaukee, WI 53211-2906 | 2009-05-28 |
| 1992947899 | Matthew William Mestelle | Physical Therapist | 2025 E Newport Ave, Milwaukee, WI 53211-2906 | 2009-03-24 |
| 1164687646 | David Charles Osmon | Clinical Neuropsychologist | 2025 E Newport Ave, Sacred Heart Rehabilitation Institute, Milwaukee, WI 53211 | 2008-07-23 |
| 1932368370 | Katherine Rogers | Speech-Language Pathologist | 2025 E Newport Ave, Milwaukee, WI 53211-2906 | 2008-06-02 |
| 1578772760 | Melanie Kay Hertzog | Occupational Therapist | 2025 E Newport Ave, Milwaukee, WI 53211-2906 | 2007-05-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602335 | Gabriella Caitrin Emanuele | Occupational Therapist | Harborchase of Shorewood, 1111 E Capitol Drive, Shorewood, WI 53211 | 2020-09-02 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1861043952 | Rosina Bloomingdale Norton | Nurse Practitioner | 1921 E Harford Ave, Milwaukee, WI 53211 | 2019-09-20 |
| 1528556255 | Renee Reckelberg | Specialist/Technologist | 3409 North Downer Avenue, Pavilion, Suite 350, Milwaukee, WI 53211 | 2018-04-27 |
| 1700325602 | Wisconsin Vision, Inc. | Optometrist | 4163 N Oakland Ave, Shorewood, WI 53211 | 2017-02-13 |
| 1750827556 | Daniel Butz M.d., S.c. | Plastic Surgery | 2350 N Lake Dr Ste 304, Milwaukee, WI 53211 | 2017-01-17 |
| 1528517232 | Therese Simonis | Speech-Language Pathologist | 2390 N Lake Drive, Milwaukee, WI 53211 | 2016-09-23 |
| 1982075701 | Katie Michel | Specialist/Technologist | 3409 N. Downer Ave, Milwaukee, WI 53211 | 2015-10-20 |
| 1255776365 | Sarah Elizabeth Brill | Social Worker | 4433 N Oakland Ave Ste D, Shorewood, WI 53211 | 2013-05-02 |
| 1679814537 | Nicole Anne Parulski | Physical Therapist | 2301 North Lake Dr, Milwaukee, WI 53211 | 2013-03-01 |
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| 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 |
|---|---|---|---|---|
| 1124649751 | Cody Scott Tesch | Specialist/Technologist | 6680 N Teutonia Ave, Milwaukee, WI 53209-3117 | 2020-05-05 |
| 1366070708 | Claire Duwell | Specialist/Technologist | 9111 W Bluemound Rd, Milwaukee, WI 53226-4506 | 2020-03-31 |
| 1851929491 | Frank Dore | Specialist/Technologist | 3265 N Oakland Ave, Milwaukee, WI 53211-3051 | 2020-03-30 |
| 1851923239 | Anna Barth | Specialist/Technologist | 1857 E Kenilworth Pl Apt 322, Milwaukee, WI 53202-4714 | 2020-02-04 |
| 1356903074 | Christian Garcia | Specialist/Technologist | 1930 W Grant St, Milwaukee, WI 53215-2614 | 2019-07-02 |
| 1801363403 | Jennifer A Merritt | Specialist/Technologist | 1245 N Broadway, Milwaukee, WI 53202-2507 | 2018-11-01 |
| 1528556255 | Renee Reckelberg | Specialist/Technologist | 3409 North Downer Avenue, Pavilion, Suite 350, Milwaukee, WI 53211 | 2018-04-27 |
| 1205344595 | Abigail Leisemann | Specialist/Technologist | 114 S 79th St, Milwaukee, WI 53214-1413 | 2018-01-20 |
| 1205299096 | Sarah Wenszell | Specialist/Technologist | 228 N 72nd St, Milwaukee, WI 53213-3752 | 2016-03-30 |
| 1396106993 | Ryan D Mccauley | Specialist/Technologist | 1732 N Prospect Ave Apt 408, Milwaukee, WI 53202-1937 | 2016-03-10 |
| Find all providers in MILWAUKEE | ||||
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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.