JUSTIN GERALD TATTERSALL (NPI# 1518479104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518479104 |
| Entity Type | Individual |
| Full Name | JUSTIN GERALD TATTERSALL |
| Practice Address |
625 E Broadway Ave Jackson WY 83001-8642 |
| Mailing Address |
Po Box 9871 Jackson WY 83002-9871 |
| Practice Telephone | 3077333636 |
| Mailing Telephone | 3074130437 |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2017-11-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WR0006X |
Registered Nurse Specialization: Registered Nurse First Assistant |
30955 | WY | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NONE | 3074130437 | 01 |
| Street Address |
625 E BROADWAY AVE |
| City | JACKSON |
| State | WY |
| Zip Code | 83001-8642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679534432 | Lars T Conway | Pathology | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2006-03-31 |
| 1154969251 | Michelle Robertson | Dietitian, Registered | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2019-12-19 |
| 1942848072 | Anna Sigrid Eide | Dietitian, Registered | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2019-12-19 |
| 1104464734 | Lisa Lauritzen Smith | Dietitian, Registered | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2019-12-13 |
| 1598325193 | Katrina Rush | Occupational Therapist | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2019-06-17 |
| 1669949590 | Elizabeth Smith Dannewald | Nurse Practitioner | 625 E Broadway Ave, Jackson, WY 83001 | 2018-10-29 |
| 1528533973 | Hanna Kirsten | Occupational Therapy Assistant | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2018-10-11 |
| 1891270500 | Jamie Loomis | Physical Therapy Assistant | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2018-09-27 |
| 1942784806 | Jared Travis Martin | Physical Therapy Assistant | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2018-09-17 |
| 1891274320 | Wendy Carbone | Physical Therapist | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2018-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861006108 | Anne Kathleen Milburn | Physical Therapist | 3620 S Park Drive, Jackson, WY 83001 | 2020-09-03 |
| 1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
| 1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
| 1982169371 | Cynthia Buck Huyffer | Social Worker | 755a Cache Creek Drive, Jackson, WY 83001 | 2019-02-10 |
| 1093281594 | Lara Cilo | Speech-Language Pathologist | 1300 W. Valley Springs Road, Jackson, WY 83001 | 2018-10-23 |
| 1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
| 1437642055 | Anna Yanchek | Physical Therapist | 1090 Us- 89, Jackson Hole, WY 83001 | 2018-06-08 |
| 1891200762 | Tyler Ross Wright | Chiropractor | 1325 Us-89, Suite 108, Jackson, WY 83001 | 2017-12-13 |
| 1073027280 | Root To Rise Counseling and Consulting, Pllc | Social Worker | 2033 Dandelion Court, Jackson, WY 83001 | 2017-11-27 |
| 1962923912 | Piper Worthington | Social Worker | 1910 High School Rd, Jackson, WY 83001 | 2017-06-29 |
| Find all providers in zip 83001 | ||||
| Taxonomy Code | 163WR0006X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Registered Nurse First Assistant |
| A perioperative registered nurse who works in collaboration with the surgeon and other health care team members to achieve optimal outcomes. The RNFA has acquired the necessary knowledge, judgment, and skills specific to the expanded role of RNFA clinical practice. Intraoperatively, the RNFA assists the surgeon. |
| Notes: Source: AORN Official Statement on RNFAs ratified by the AORN House of Delegates in 2004. [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003349465 | Teton Surgical Assist Services LLC | Registered Nurse | 1200 Melody Creek Ln, Jackson, WY 83001-8982 | 2017-04-04 |
| 1144732736 | 4js LLC | Registered Nurse | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2017-11-03 |
| 1083149181 | John Causey | Registered Nurse | 1325 E Fortification St, Jackson, MS 39202-2442 | 2017-04-26 |
| 1053768879 | Jodie Kilby | Registered Nurse | 2500 N State St, Jackson, MS 39216-4500 | 2016-05-22 |
| 1073969952 | Wanda G Bounds | Registered Nurse | 2500 N State St, Jackson, MS 39216-4500 | 2016-05-10 |
| 1164834362 | Maricyl Terry | Registered Nurse | 971 Lakeland Dr Ste 950, Jackson, MS 39216-4608 | 2014-05-22 |
| 1992120604 | Summers Helping Hands, LLC | Registered Nurse | 2105 Lilac Ln, Jackson, WY 83001-8560 | 2014-03-04 |
| 1730480286 | Melissa Jones | Registered Nurse | 1421 N State St, Suite 403, Jackson, MS 39202-1658 | 2010-11-14 |
| 1336471119 | Melinda J. Engel | Registered Nurse | 971 Lakeland Dr, Ste 750 Mississippi Oncology Associates, Jackson, MS 39216 | 2010-02-04 |
| 1689903858 | Laura C Evans | Registered Nurse | 971 Lakeland Dr, Suite 1250, Jackson, MS 39216-4643 | 2009-12-16 |
| Find all providers in JACKSON | ||||
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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.