MARK DUANE RUSSELL (NPI# 1306867049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306867049 |
Entity Type | Individual |
Full Name | MARK DUANE RUSSELL |
Credential | ATC, CSCS |
Practice Address |
3950 Hollywood Rd Ste 140 Saint Joseph MI 49085-9151 |
Mailing Address |
4858 Sadler Dr Watervliet MI 49098-8703 |
Practice Telephone | 2695567150 |
Mailing Telephone | 2694635859 |
Enumeration Date | 2006-07-21 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831710771 | Mark William Russell | Dentist | 461 Western Blvd Ste 104, Jacksonville, NC 28546-7637 | 2020-05-01 |
1144752221 | Mark Russell | Social Worker | 475 Sykesville Troutville Rd, Punxsutawney, PA 15767-4367 | 2017-03-29 |
1154767267 | Mark Stephen Russell Jr. | Counselor | 3901 Airport Fwy Ste 107, Bedford, TX 76021-6117 | 2013-05-15 |
1437314366 | Mark William Russell | Community Health Worker | 108 Schooner Landing Dr, Edenton, NC 27932-8833 | 2008-07-21 |
1639137540 | Mark Russell | Internal Medicine | 13024 Hesperia Rd Ste 103, Victorville, CA 92395-8303 | 2006-05-02 |
1689671315 | Mark Dale Russell | Chiropractor | 5309 44th St, Lubbock, TX 79414-1321 | 2005-07-07 |
1154827756 | Mark Russell | Student in an Organized Health Care Education/Training Program | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2018-04-03 |
1033654967 | Mark Russell | Pharmacist | 2920 Knoxville Center Dr, Knoxville, TN 37924-2013 | 2017-01-02 |
1477097392 | Mark Russell | Social Worker | 302 S Spring St, Tupelo, MS 38804-4853 | 2016-12-12 |
1134463870 | Mark Joseph Russell | Occupational Therapist | 275 East Main Street, Frankfort, KY 40621-0001 | 2012-11-19 |
Street Address |
3950 HOLLYWOOD RD STE 140 |
City | SAINT JOSEPH |
State | MI |
Zip Code | 49085-9151 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326510116 | Tracie Lyn Wier | Physical Therapist | 3950 Hollywood Rd Ste 140, Saint Joseph, MI 49085-9151 | 2018-12-18 |
1124598180 | Cara Michele Gillespie | Physical Therapist | 3950 Hollywood Rd Ste 140, Saint Joseph, MI 49085-9151 | 2018-12-03 |
1942770144 | Abby Dill | Physical Therapist | 3950 Hollywood Rd Ste 140, Saint Joseph, MI 49085-9151 | 2018-11-29 |
1720557440 | Sara Mccomish | Physical Therapist | 3950 Hollywood Rd Ste 140, Saint Joseph, MI 49085-9151 | 2018-11-26 |
1609345313 | Todd Earl Rose | Physical Therapist | 3950 Hollywood Rd Ste 140, Saint Joseph, MI 49085-9151 | 2018-11-26 |
1417426131 | Sherry Ellen Becker | Physical Therapist | 3950 Hollywood Rd Ste 140, Saint Joseph, MI 49085-9151 | 2018-11-26 |
1043789787 | Kathryn E Collins | Physical Therapist | 3950 Hollywood Rd Ste 140, Saint Joseph, MI 49085-9151 | 2018-11-23 |
1336618172 | Heidi Christa Gonzalez | Physical Therapist | 3950 Hollywood Rd Ste 140, Saint Joseph, MI 49085-9151 | 2018-11-23 |
1538638473 | Michael Anthony O'hearn | Physical Therapist | 3950 Hollywood Rd Ste 140, Saint Joseph, MI 49085-9151 | 2018-11-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134758949 | Ahmed Elshareif | Student in an Organized Health Care Education/Training Program | Lakeland Health, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2020-04-03 |
1033747225 | Ezra Fox | Student in an Organized Health Care Education/Training Program | Lakeland Health- Gme, 1234 Napier Avenue, St. Joseph, MI 49085 | 2020-04-01 |
1679033930 | Asad Butt | Student in an Organized Health Care Education/Training Program | Lakeland Health-gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2019-03-22 |
1184194714 | Benjamin Phillip Knuth | Physical Therapist | 3950 Hollywood Road, Suite 140, Saint Joseph, MI 49085 | 2018-11-27 |
1336624279 | Brandi Chatot | Counselor | 1101 Broad Street #8, Saint Joseph, MI 49085 | 2018-09-26 |
1396239562 | Lakeland Medical Practices | Family Medicine | 2500 Niles Ave., Suite 1, St. Joseph, MI 49085 | 2018-06-20 |
1760976518 | Premier Health Associates, Inc. | Home Health | 1111 Main Sr, St Joseph, MI 49085 | 2018-06-15 |
1053817783 | Chantell Strong | Student in an Organized Health Care Education/Training Program | Lakeland Health - Gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2018-04-02 |
1386144053 | Anjana Gupta, Dds, Pllc | Dentist | 2800 Niles Road, Saint Joseph, MI 49085 | 2018-02-19 |
1356858997 | Hope Reborn Counseling, Pllc | Counselor | 2816 Willa Dr, Saint Joseph, MI 49085 | 2018-01-04 |
Find all providers in zip 49085 |
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 |
---|---|---|---|---|
1225592421 | Andrea Canas | Specialist/Technologist | 508 Sherwood Dr, Saint Joseph, IL 61873-9468 | 2019-01-22 |
1538661186 | Jesse Anderson | Specialist/Technologist | 102 Iverson St W, Saint Joseph, MN 56374-4650 | 2018-02-28 |
1437504594 | Jenna Beth Zettel | Specialist/Technologist | 5655 S 4th St, Saint Joseph, MO 64504-1708 | 2016-04-26 |
1861856403 | Hannah E Warnert | Specialist/Technologist | 33674 83rd Ave, Saint Joseph, MN 56374-9786 | 2016-04-10 |
1982074175 | Timothy Clair Mcnair | Specialist/Technologist | 1446 Deerfield St, Saint Joseph, MI 49085-9763 | 2015-09-30 |
1033586466 | Cara Conrad | Specialist/Technologist | 4367 Hart Dr, Saint Joseph, MI 49085-9310 | 2015-09-02 |
1861873952 | Edison Derr II | Specialist/Technologist | 2214 Maple St, Saint Joseph, MO 64507-1413 | 2015-06-15 |
1992198014 | Madeline Svec | Specialist/Technologist | 3170 Estates Dr N, Saint Joseph, MI 49085-3435 | 2015-03-13 |
1174860944 | Blaise D. Kriley | Specialist/Technologist | 4525 Downs Dr, Saint Joseph, MO 64507-2246 | 2013-01-13 |
1588693311 | Kate Lee Esely | Specialist/Technologist | 5110 Mockingbird Ln, Saint Joseph, MO 64506-3331 | 2006-07-02 |
Find all providers in SAINT JOSEPH |
City | SAINT JOSEPH |
Zip Code | 49085 |
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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.