MR. PATRICK DEACHILLA (NPI# 1245657477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245657477 |
| Entity Type | Individual |
| Full Name | MR. PATRICK DEACHILLA |
| Credential | MS, LAT, ATC |
| Practice Address |
5601 Loch Raven Blvd Russell Morgan Building Suite 405 Baltimore MD 21239-2945 |
| Mailing Address |
438 E Cross St Baltimore MD 21230-4126 |
| Practice Telephone | 4434444764 |
| Mailing Telephone | 7175155088 |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2014-03-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
A0000409 | MD | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
5601 LOCH RAVEN BLVD RUSSELL MORGAN BUILDING SUITE 405 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21239-2945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316940588 | Paul Byron Fowler | Specialist | 5601 Loch Raven Blvd, Baltimore, MD 21239-2905 | 2005-05-23 |
| 1992328017 | Kaitlin Lee | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-05-22 |
| 1023646692 | Akiko Rockers | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-03-30 |
| 1578199519 | Erica Wilson | Pharmacist | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-03-22 |
| 1154952497 | Kimberly Jo Jenko | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-01-27 |
| 1679103576 | Nerland Dimanche | Registered Nurse | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2020-01-20 |
| 1063058782 | Simcha Gratz | Nurse Practitioner | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-11-19 |
| 1548817737 | Christopher Burgess | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-08-22 |
| 1114571809 | Lauren Delmonico | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-07-30 |
| 1750943411 | Sana Tanveer Ahmed | Physician Assistant | 5601 Loch Raven Blvd, Baltimore, MD 21239-2945 | 2019-07-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255809273 | Books of Color, LLC | Student in an Organized Health Care Education/Training Program | 1222 Walker Ave, Baltimore, MD 21239 | 2018-11-07 |
| 1902381353 | Brandon Wilson | Physician Assistant | 5601 Lochraven Blvd, Baltimore, MD 21239 | 2018-10-02 |
| 1629563879 | Ashley C Sayles | Nurse Practitioner | 5601 Loch Raven Blvd Ste 200, Baltimore, MD 21239 | 2018-06-28 |
| 1164940656 | Tarnisha Fitzgerald | Nurse Practitioner | 1601 East Belvedere Avenue, Baltimore, MD 21239 | 2017-09-05 |
| 1083153803 | J.pope & Associates, LLC | Counselor | 1800 E. Northern Pkwy #28031, Baltimore, MD 21239 | 2017-02-13 |
| 1417336017 | Mana Ali | Psychologist | 5601 Loch Raven Blvd Ste 406, Johns Hopkins Som Dept of Physical Med and Rehab, Baltimore, MD 21239 | 2015-05-28 |
| 1730597766 | Ramona Taylor-knox | Counselor | 1700 Meridian Drive, Suite 611, Baltimore, MD 21239 | 2014-07-22 |
| 1013259142 | Innovative Healing Solutions,llc | Social Worker | 1302 Silverthorne Rd, Baltimore, MD 21239 | 2013-03-27 |
| 1962744268 | Mohamad Hanouneh | Internal Medicine | 5601 Loch Raven Blvd Ste 3n, Baltimore, MD 21239 | 2013-03-25 |
| 1164713350 | Vanessa G Brown | Pharmacist | 5618 The Alameda, Baltimore, MD 21239 | 2011-04-22 |
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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 |
|---|---|---|---|---|
| 1588299028 | Shaneka Victor | Specialist/Technologist | 1526 E Baltimore St, Baltimore, MD 21231-1424 | 2020-03-05 |
| 1285266064 | Marquis Coleman | Specialist/Technologist | 1 Tomahawk Ter, Baltimore, MD 21220-3677 | 2020-02-10 |
| 1891339875 | Mallory Gomes | Specialist/Technologist | 351 W Camden St Ste 500, Baltimore, MD 21201-7912 | 2019-11-01 |
| 1396306379 | Diane M Finlayson | Specialist/Technologist | 1421 Clarkview Rd Ste 206, Baltimore, MD 21209-2106 | 2019-06-21 |
| 1164984118 | Joshua Fike | Specialist/Technologist | 1700 East Cold Spring Lane, Baltimore, MD 21251-0002 | 2019-04-01 |
| 1427513910 | Joseph Scott Celentano | Specialist/Technologist | 7108 Rodgers Ct, Baltimore, MD 21212-1523 | 2019-02-08 |
| 1295233021 | Ethan Schmelzer | Specialist/Technologist | 270 Holder Rd Nw, Baltimore, OH 43105-9713 | 2018-01-26 |
| 1659891976 | Erin Mcgovern | Specialist/Technologist | Towson Sports Medicine 8322 Bellona Ave, Suite Number 100, Baltimore, MD 21204 | 2017-06-27 |
| 1104357409 | Mollie Marie Swindell | Specialist/Technologist | 4405 Kenwood Ave Unit A, Baltimore, MD 21206-2032 | 2017-03-27 |
| 1699210229 | Kim N. Dang | Specialist/Technologist | 7 Whitelaw Pl Apt Tb, Baltimore, MD 21236 | 2017-01-06 |
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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.