THEODORE VANDERMEUSE (NPI# 1326456245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326456245 |
| Entity Type | Individual |
| Full Name | THEODORE VANDERMEUSE |
| Credential | ATC/LAT |
| Practice Address |
2817 New Pinery Rd Portage WI 53901-9240 |
| Practice Telephone | 6087456290 |
| Mailing Telephone | 6087456290 |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2014-07-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2817 NEW PINERY RD |
| City | PORTAGE |
| State | WI |
| Zip Code | 53901-9240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174506307 | James T Gariti Sr. | Emergency Medicine | 2817 New Pinery Rd, Divine Savior Healthcare Inc, Portage, WI 53901-9257 | 2005-11-22 |
| 1881208635 | Sophie M Tessner | Pharmacist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2020-08-31 |
| 1164047015 | Stephanie Jo Holt | Nurse Practitioner | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2020-06-16 |
| 1770132268 | Anna Carole Hormig | Registered Nurse | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-09-06 |
| 1790338655 | Andrea Olsen | Occupational Therapist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-19 |
| 1316590417 | Nicole Rae Sletten | Occupational Therapy Assistant | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-18 |
| 1851944078 | Andrew Larson | Physical Therapist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-17 |
| 1780236067 | Danielle Debruyne | Physical Therapist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-16 |
| 1063077055 | Dillon Via | Physician Assistant | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-05-06 |
| 1659843886 | Andrew Benton Padley | Registered Nurse | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2018-12-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
| 1881872158 | Marta Jean Jindra | Physical Therapist | 626 E Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1134314552 | Kristina Hellenbrand | Physical Therapist | 2639 New Pinery Road, Suite 2, Portage, WI 53901 | 2007-09-10 |
| 1689727810 | Gregory Allan Bindl | Chiropractor | 2121new Pinery Rd, Portage, WI 53901 | 2007-01-19 |
| 1720149156 | Timothy J Rosin Dds Sc | Dentist | 2570 New Pinery Rd, Portage, WI 53901 | 2006-12-12 |
| 1710083779 | Currani Seubert Dental Office LLC | Dentist | 260 W Cook St, Portage, WI 53901 | 2006-09-16 |
| 1225090525 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 2977 Cty Hwy Cx, Portage, WI 53901 | 2006-04-04 |
| Find all providers in zip 53901 | ||||
| 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 |
|---|---|---|---|---|
| 1487255642 | Siarra Grace Crum | Specialist/Technologist | 102 Bellwood Lane, Portage, PA 15946-1441 | 2020-11-04 |
| 1043841711 | Megan S Kaminski | Specialist/Technologist | 2273 Sandwood St, Portage, IN 46368-2434 | 2020-01-30 |
| 1386285740 | Natalie Mcclish | Specialist/Technologist | 5640 Grand Traverse Ln, Portage, MI 49024-1129 | 2019-10-07 |
| 1790251981 | Jade Nycole Aguilar | Specialist/Technologist | 5945 Waterside Dr Apt 2, Portage, IN 46368-4933 | 2018-10-16 |
| 1306320866 | Rachel O'boyle | Specialist/Technologist | 8135 S Westnedge Ave, Portage, MI 49002-5433 | 2018-09-20 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1033591797 | Corbett Lafrance | Specialist/Technologist | 3511 Fawn Cove Ln Apt 1, Portage, MI 49024-4778 | 2015-06-18 |
| 1518363480 | Christopher Miller | Specialist/Technologist | 5441 Meredith St, Apt K, Portage, MI 49002-2143 | 2014-11-05 |
| 1295945046 | Matthew Steven Bekkedal | Specialist/Technologist | 2817 New Pinery Rd Ste 103, Portage, WI 53901-9257 | 2007-05-23 |
| 1699791079 | Kathleen Levandoski | Specialist/Technologist | 6154 Lute Rd, Portage, IN 46368-5010 | 2006-07-15 |
| Find all providers in PORTAGE | ||||
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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.