MATTHEW THOMAS JAKSETIC (NPI# 1366776452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366776452 |
| Entity Type | Individual |
| Full Name | MATTHEW THOMAS JAKSETIC |
| Credential | ATC |
| Practice Address |
1450 Aviation Dr 201 Hailey ID 83333-8785 |
| Mailing Address |
Po Box 2561 Ketchum ID 83340-2561 |
| Practice Telephone | 2087278281 |
| Practice Fax Number | 2087278285 |
| Mailing Telephone | 9062824876 |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2010-06-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT-364 | ID | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
959039 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1450 AVIATION DR 201 |
| City | HAILEY |
| State | ID |
| Zip Code | 83333-8785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023073897 | Thomas E Archie Jr. | Acupuncturist | 1450 Aviation Dr, Suite 100, Hailey, ID 83333-8785 | 2006-04-17 |
| 1134556814 | Gay M Miremont | Social Worker | 1450 Aviation Dr, Ste 202, Hailey, ID 83333-8785 | 2013-09-26 |
| 1639499809 | Jesse Foster | Physical Therapist | 1450 Aviation Dr, Hailey, ID 83333-8785 | 2010-06-10 |
| 1609104363 | Kristin Bevers | Physical Therapist | 1450 Aviation Dr, Suite 201, Hailey, ID 83333-8767 | 2009-11-18 |
| 1083842272 | Amy C Drumm | Family Medicine | 1450 Aviation Dr, Ste 100, Hailey, ID 83333-8785 | 2009-06-25 |
| 1821212788 | Timothy J Stoddard | Psychiatry & Neurology | 1450 Aviation Dr, Suite 202, Hailey, ID 83333-8785 | 2007-04-12 |
| 1982620787 | Julie A Lyons | Family Medicine | 1450 Aviation Dr, Suite 100, Hailey, ID 83333-8785 | 2006-07-14 |
| 1003852849 | Cortney A Vandenburgh | Family Medicine | 1450 Aviation Dr, Suite 100, Hailey, ID 83333-8785 | 2006-06-21 |
| 1164463964 | Lois Adrian | Family Medicine | 1450 Aviation Dr, Suite 100, Hailey, ID 83333-8785 | 2006-06-10 |
| 1548201932 | Barton Adrian | Pediatrics | 1450 Aviation Dr, Suite 100, Hailey, ID 83333-8785 | 2006-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227534 | Bonnie Bray | Community/Behavioral Health | 99 East Fork Road, Hailey, ID 83333 | 2020-05-18 |
| 1174010573 | Kh Counseling & Health Center, LLC | Social Worker | 409 N Main Street, Hailey, ID 83333 | 2018-04-20 |
| 1306126909 | Brad A Bjorsness | Pharmacist | 911 N. Main, Hailey, ID 83333 | 2011-08-26 |
| 1821384520 | Lee Pesky Learning Center | Local Education Agency (LEA) | 1060 Fox Acres Rd, Hailey, ID 83333 | 2011-06-22 |
| 1245478684 | Marlin Layne Felton | Pharmacist | 830 Deerfield Drive, Hailey, ID 83333 | 2009-01-22 |
| 1023230992 | Lawrence I Weiner | Psychiatry & Neurology | 202 Indian Creek Rd, Hailey, ID 83333 | 2007-05-02 |
| 1730308305 | Betty Lee Brooks | Counselor | 1811 Laurelwood Dr, Hailey, ID 83333 | 2007-04-24 |
| 1639231459 | Mary Ellen Oleary | Physical Therapist | 150 6th Ave, Hailey, ID 83333 | 2006-12-15 |
| 1851450498 | Donald Edwin Spengler | Dentist | 400 S Main Street, Hailey, ID 83333 | 2006-12-08 |
| 1831268341 | Cynthia Kay Unger | Dentist | 219 S River, Hailey, ID 83333 | 2006-11-07 |
| Find all providers in zip 83333 | ||||
| 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 |
|---|---|---|---|---|
| 1225360035 | David Reid Allred | Specialist/Technologist | 1250 Fox Acres Rd, Hailey, ID 83333-8824 | 2010-02-03 |
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|---|---|---|---|---|
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| 1811515067 | Lexis Fouts | Specialist/Technologist | 617 W Taylor Ave # A, Moscow, ID 83843-2411 | 2020-07-13 |
| 1073131629 | Shaelynn Meek | Specialist/Technologist | 1350 E Warm Springs Ave, Post Falls, ID 83854-9693 | 2020-07-09 |
| 1063039204 | Jadelyn Taylor Eisele | Specialist/Technologist | 707 Railroad St Apt 4, Moscow, ID 83843-2381 | 2020-07-04 |
| 1366069593 | Tyler Hempfling Volkmann | Specialist/Technologist | 924 Indian Hills Dr, Moscow, ID 83843-5096 | 2020-07-03 |
| 1174149389 | Santiago A Segura Barron | Specialist/Technologist | Holt Arena 550 Memorial Drive Building 50, Pocatello, ID 83209-0001 | 2020-06-23 |
| 1942824545 | Maya S Gough | Specialist/Technologist | 10284 W Virginia City St, Star, ID 83669-5619 | 2020-05-31 |
| 1013531680 | Dalton Tanner Pitts | Specialist/Technologist | 1433 W A St, Moscow, ID 83843-3274 | 2020-05-29 |
| 1083238646 | Shyla Marie Flavel | Specialist/Technologist | 1022 W Recess Way, Kuna, ID 83634-2459 | 2020-05-29 |
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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.