NICOLE GORVIN (NPI# 1225428808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225428808 |
| Entity Type | Individual |
| Full Name | NICOLE GORVIN |
| Credential | ATR |
| Practice Address |
5101 Highway 101 Minnetonka MN 55345-4163 |
| Mailing Address |
4621 Manchester Rd Mound MN 55364-9141 |
| Practice Telephone | 9525124200 |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2015-02-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2578 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
5101 HIGHWAY 101 |
| City | MINNETONKA |
| State | MN |
| Zip Code | 55345-4163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417587205 | Pain Partners LLC | Pharmacist | 15225 Wild Wings Court, Minnetonka, MN 55345 | 2020-01-21 |
| 1356811608 | Caitlin Marie Peterson | Specialist/Technologist | 15708 Wood Knoll Lane, Minnetonka, MN 55345 | 2018-11-29 |
| 1649747007 | West Side Counseling LLC | Community/Behavioral Health | 10520 Wayzata Blvd., Suite 100, Minnetonka, MN 55345 | 2018-10-24 |
| 1689173247 | Theresa Tsuchiya | Psychologist | Relate, Inc., 5125 County Road 101, Suite 300, Minnetonka, MN 55345 | 2018-02-08 |
| 1497264147 | Minnetonka Assisted Living and Hospice | Community Health Worker | 14667 Lake Street Extension, Minnetonka, MN 55345 | 2017-09-26 |
| 1619494671 | Shree Revenue Management | Durable Medical Equipment & Medical Supplies | 6117, Creek Ridge Ct, Minnetonka, MN 55345 | 2017-08-29 |
| 1538606876 | Stefani Yanizeski | Speech-Language Pathologist | Minnesota Autism Center, 5710 Baker Road, Minnetonka, MN 55345 | 2017-01-25 |
| 1790157469 | Greg Anderson | Psychologist | 5125 County Road 101, #300, Relate, Inc., Minnetonka, MN 55345 | 2015-10-21 |
| 1861896375 | Kristine L Smith | Marriage & Family Therapist | 5125 County Road 101 Suite 300, Minnetonka, MN 55345 | 2014-10-13 |
| 1982014460 | Miranda Jean Johnson | Speech-Language Pathologist | 15265 Minnetonka Blvd., Minnetonka, MN 55345 | 2014-05-06 |
| Find all providers in zip 55345 | ||||
| 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 |
|---|---|---|---|---|
| 1356811608 | Caitlin Marie Peterson | Specialist/Technologist | 15708 Wood Knoll Lane, Minnetonka, MN 55345 | 2018-11-29 |
| 1821404021 | Kristen Nietfeld | Specialist/Technologist | 6125 Chasewood Pkwy Apt 123, Minnetonka, MN 55343-4376 | 2014-07-08 |
| 1275960338 | Kristin Frances Kutch | Specialist/Technologist | 5101 County Road 101, Minnetonka, MN 55345 | 2013-10-03 |
| 1891045316 | Live 2 B Healthy Senior Fitness, LLC | Specialist/Technologist | 6110 Blue Circle Dr, Suite 230, Minnetonka, MN 55343-9128 | 2012-09-12 |
| 1417592155 | Rachel Hadges | Specialist/Technologist | 5501 Feltl Rd, Minnetonka, MN 55343-3944 | 2019-11-15 |
| 1982159216 | Kyle Mccuskey | Specialist/Technologist | 5101 County Road 101, Minnetonka, MN 55345-4163 | 2016-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092165 | Jamie Lynn Erickson | Specialist/Technologist | 43628 374th Ln, Aitkin, MN 56431-4027 | 2020-10-27 |
| 1760082044 | Craig Daniel Merten | Specialist/Technologist | 5045 Division Ave # 5575, White Bear Lake, MN 55110-2663 | 2020-10-27 |
| 1154928927 | Heidi Frey | Specialist/Technologist | 4554 Lake Park Ct, Eagan, MN 55122-2515 | 2020-10-05 |
| 1851906887 | Teddy Ray Gildersleeve | Specialist/Technologist | 37320 Oriole Ave, Lindstrom, MN 55045-9109 | 2020-09-15 |
| 1851906697 | Tadd William Berg | Specialist/Technologist | 2415 W 9th St, Duluth, MN 55806-1150 | 2020-09-09 |
| 1952916793 | Megan Marie Hautajarvi | Specialist/Technologist | 2536 Peace Dr, Duluth, MN 55811-2971 | 2020-09-09 |
| 1871108795 | Bryce Mershon Beamish | Specialist/Technologist | 3501 Lowell St, Wayzata, MN 55391-3411 | 2020-09-09 |
| 1043825961 | Kevin Eskuri | Specialist/Technologist | 8090 172nd St W, Lakeville, MN 55044-6206 | 2020-09-09 |
| 1952916876 | Elizabeth Marie Altendorf | Specialist/Technologist | 1621 397th Ave Ne, Stanchfield, MN 55080-3303 | 2020-09-09 |
| 1699380519 | Kourtney Jean Palmi | Specialist/Technologist | 4922 Howard Gnesen Rd, Duluth, MN 55803-2710 | 2020-09-09 |
| Find all providers with the same taxonomy | ||||
| City | MINNETONKA |
| Zip Code | 55345 |
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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.