MRS. MALLERY GRAY GANNAWAY (NPI# 1306353685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306353685 |
| Entity Type | Individual |
| Full Name | MRS. MALLERY GRAY GANNAWAY |
| Credential | AA |
| Practice Address |
12301 N Macarthur Blvd Apt 304 Oklahoma City OK 73142-3039 |
| Practice Telephone | 4054067112 |
| Mailing Telephone | 4054067112 |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2018-01-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
OK | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 737 | OK | Student, Health Care |
| Street Address |
12301 N MACARTHUR BLVD APT 304 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73142-3039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184003790 | Advance Physicians Group LLC | Clinic/Center | 13401 N Macarthur Blvd, Oklahoma City, OK 73142 | 2015-05-28 |
| 1366840084 | Lindsey Jackson | Case Manager/Care Coordinator | 12051 Parkland Pl, Oklahoma City, OK 73142 | 2014-12-11 |
| 1164866737 | Vitality Wellness | Clinic/Center | 5740 Nw 135th St., Oklahoma City, OK 73142 | 2013-04-25 |
| 1356694558 | Joel Mitchell Sprinkle | Community Health Worker | 13100 Brandon Pl, Oklahoma City, OK 73142 | 2012-10-25 |
| 1689923856 | Sampson Mcsidney | Case Management | 14717 Hollyhock Dr, Oklahoma City, OK 73142 | 2012-09-04 |
| 1992087860 | Derek Reed Mccarver | Pharmacist | 1400 E. 2nd St, Edmond, OK 73142 | 2011-09-15 |
| 1326335811 | Laser Spine Surgery Center of Oklahoma, LLC | Clinic/Center | 4727 Gaillardia Parkway, Suite 150, Oklahoma City, OK 73142 | 2011-07-05 |
| 1215220801 | James Kenneth Fisher | Psychologist | 12522 Abbotts Way, Oklahoma City, OK 73142 | 2011-05-16 |
| 1174850408 | Diagnostic Laboratory of Oklahoma, LLC | Clinical Medical Laboratory | 5911 West Memorial Road, Oklahoma City, OK 73142 | 2009-11-06 |
| 1417113275 | Reuben Seth Thomas | Optometrist | 6200 W Memorial Rd Ste A, Oklahoma City, OK 73142 | 2008-07-31 |
| Find all providers in zip 73142 | ||||
| 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 |
|---|---|---|---|---|
| 1679043012 | Maria Isabel Rendon | Specialist/Technologist | 1817 Nw 15th St, Oklahoma City, OK 73106-2023 | 2018-11-28 |
| 1679092662 | Allison Hadley | Specialist/Technologist | 10900 S Pennsylvania Ave, Oklahoma City, OK 73170-4244 | 2017-09-12 |
| 1609302215 | Yolanda Denise Zamarripa | Specialist/Technologist | 4436 Nw 36th St Apt 6, Oklahoma City, OK 73112-2720 | 2017-05-03 |
| 1972038065 | Rainee Lyne Ball | Specialist/Technologist | 5937 Nw 59th Ct, Oklahoma City, OK 73122-7114 | 2017-04-26 |
| 1326571860 | Damon Glass | Specialist/Technologist | 3110 Sw 89th St Ste C, Oklahoma City, OK 73159-7920 | 2017-04-11 |
| 1205283819 | Jessica Jenkins | Specialist/Technologist | 14400 N Portland Ave, Oklahoma City, OK 73134-4007 | 2016-05-24 |
| 1760849350 | Alisha Grisby | Specialist/Technologist | 11605 Copper Trails Ln, Oklahoma City, OK 73170-4486 | 2016-01-27 |
| 1700243532 | Howard Collin Gentry | Specialist/Technologist | 1231 Nw 79th St, Oklahoma City, OK 73114-1522 | 2016-01-25 |
| 1578938221 | Jeremy Randall | Specialist/Technologist | 1820 Nw 17th St, Oklahoma City, OK 73106-1802 | 2015-12-07 |
| 1730553512 | Phillip Tucker | Specialist/Technologist | 12613 S Western Ave, Oklahoma City, OK 73170-6903 | 2015-11-17 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73142 |
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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.