WYATT HENKENIUS (NPI# 1326697400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326697400 |
| Entity Type | Individual |
| Full Name | WYATT HENKENIUS |
| Credential | LAT, ATC |
| Practice Address |
285 Forest Grove Dr Pewaukee WI 53072-3782 |
| Mailing Address |
1076 Jasper Dr West Des Moines IA 50266-3312 |
| Practice Telephone | 6417459378 |
| Mailing Telephone | 6417459378 |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
083438 | IA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4349 Merle Hay Rd, Des Moines, IA 503102303 | 6417459378 |
| Street Address |
285 FOREST GROVE DR |
| City | PEWAUKEE |
| State | WI |
| Zip Code | 53072-3782 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477673556 | Healthy Smiles Dental Care, S.c. | Dentist | 285 Forest Grove Dr, Suite 201, Pewaukee, WI 53072-3782 | 2007-03-30 |
| 1225537129 | Mark Joseph Sniadecki | Specialist/Technologist | 285 Forest Grove Dr, Pewaukee, WI 53072-3782 | 2018-02-06 |
| 1942651823 | Alessandra Stifter | Specialist/Technologist | 285 Forest Grove Dr, Pewaukee, WI 53072-3782 | 2016-06-22 |
| 1891954822 | Kurt Edward Bauer | Acupuncturist | 285 Forest Grove Dr, Suite 208, Pewaukee, WI 53072-3782 | 2008-06-05 |
| 1164542239 | Afshin Hamedi | Dentist | 285 Forest Grove Dr, Suite 201, Pewaukee, WI 53072-3782 | 2007-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740805423 | Froedtert Health Neighborhood Hospital, LLC | General Acute Care Hospital | 209 Pewaukee Rd, Pewaukee, WI 53072 | 2020-06-09 |
| 1871122556 | Mary Kofigah | Nurse Practitioner | 21150 W. Capital Dr., Brookfield, WI 53072 | 2020-04-05 |
| 1609436559 | Brianna Kelly Bates | Optometrist | 1440 Capitol Drive, Suite B, Pewaukee, WI 53072 | 2019-06-13 |
| 1932767316 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1440 Capital Drive, Suite B, Pewaukee, WI 53072 | 2019-05-31 |
| 1417426925 | Edward Dow | Psychologist | W268n1988 Shooting Star Road, Pewaukee, WI 53072 | 2018-11-14 |
| 1346664869 | Jane Sweney | Counselor | 325 Forest Grove Drive, Pewaukee, WI 53072 | 2014-02-05 |
| 1093082182 | Kristin Elizabeth Thieneman | Pharmacist | 443 Pewaukee Road, Pewaukee, WI 53072 | 2011-11-17 |
| 1922318393 | Ariane Machin | Psychologist | 161 W. Wisconsin Ave #2b, Pewaukee, WI 53072 | 2010-10-19 |
| 1083930879 | Scott Robert Borkenhagen | Student in an Organized Health Care Education/Training Program | 384 Willow Grove Dr., Unit D, Pewaukee, WI 53072 | 2010-04-19 |
| 1912174988 | Robert Thomas Lynch | Dentist | 234 Oakton Ave, Pewaukee, WI 53072 | 2008-05-09 |
| Find all providers in zip 53072 | ||||
| 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 |
|---|---|---|---|---|
| 1437639143 | Nicole Elizabeth Arnold | Specialist/Technologist | 740 W Wisconsin Ave Apt 1, Pewaukee, WI 53072-2356 | 2018-08-21 |
| 1275930505 | Rod Joseph | Specialist/Technologist | 285 Forest Grove Dr Ste 207, Pewaukee, WI 53072-3738 | 2014-12-02 |
| 1366462319 | Mary Colleen Daly | Specialist/Technologist | 2835 N Grandview Blvd, Siute 100, Pewaukee, WI 53072-5531 | 2006-07-20 |
| 1639721327 | Marcus Thoma | Specialist/Technologist | 2900 Golf Rd, Pewaukee, WI 53072-5449 | 2019-07-12 |
| 1861992570 | Kelson James Wann | Specialist/Technologist | 285 Forest Grove Dr Ste 207, Pewaukee, WI 53072-3738 | 2018-02-19 |
| 1659871812 | Taylor Leigh Tassoul | Specialist/Technologist | 285 Forest Grove Dr Ste 207, Pewaukee, WI 53072-3738 | 2018-02-14 |
| 1225537129 | Mark Joseph Sniadecki | Specialist/Technologist | 285 Forest Grove Dr, Pewaukee, WI 53072-3782 | 2018-02-06 |
| 1407355498 | Kayla A Huerta | Specialist/Technologist | 285 Forest Grove Dr Ste 207, Pewaukee, WI 53072-3738 | 2018-02-06 |
| 1942651823 | Alessandra Stifter | Specialist/Technologist | 285 Forest Grove Dr, Pewaukee, WI 53072-3782 | 2016-06-22 |
| 1215296249 | Maria Kohlwey | Specialist/Technologist | 2835 N Grandview Blvd, Ste. 100, Pewaukee, WI 53072-5546 | 2012-05-11 |
| Find all providers in PEWAUKEE | ||||
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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.