STACEY S PETRIC (NPI# 1538433818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538433818 |
| Entity Type | Individual |
| Full Name | STACEY S PETRIC |
| Credential | ATC |
| Practice Address |
2090 Woodwinds Dr Woodbury MN 55125-2522 |
| Practice Telephone | 6519685200 |
| Enumeration Date | 2012-03-03 |
| Last Update Date | 2012-03-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2090 WOODWINDS DR |
| City | WOODBURY |
| State | MN |
| Zip Code | 55125-2522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538137732 | Amy Stromwall Beacom | Emergency Medicine | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2006-03-14 |
| 1659928703 | Austin Moore | Physical Therapist | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2019-08-23 |
| 1962965848 | Molly Michelle Mullee | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2019-04-09 |
| 1306312814 | Sarah Renee Wittak | Occupational Therapist | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2018-10-23 |
| 1124517677 | Joshua Allan Albarado | Occupational Therapist | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2018-05-09 |
| 1013458009 | Abby Mohr | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2017-03-10 |
| 1366898371 | William Thompson | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2016-05-09 |
| 1598125817 | Nathan L Reimnitz | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2016-02-29 |
| 1861851172 | Anthony J Sterk | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2016-02-15 |
| 1386025187 | Alex Villano | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2015-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
| 1689218091 | Jordan Schmidt | Student in an Organized Health Care Education/Training Program | 1740 Welr Dr. #24, Woodbury, MN 55125 | 2019-10-30 |
| 1629619580 | Mackenzie Ann Funke | Occupational Therapist | 721 Commerce Drivve, Woodbury, MN 55125 | 2019-10-02 |
| 1700342029 | Darcy Stivland | Counselor | 1811 Weir Drive #270, Woodbury, MN 55125 | 2019-02-11 |
| 1235609884 | Elizabeth Kennedy Ward | Psychologist | 7582 Currell Blvd Suite 208, Woodbury, MN 55125 | 2018-11-27 |
| 1528573664 | Cory Lee Baumeister | Counselor | 652 Bielenberg Dr, Woodbury, MN 55125 | 2017-12-12 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1366988826 | Mark Your Home Health Care LLC | Home Health | 6053 Hudson Road, Suite 200, Woodbury, MN 55125 | 2017-01-09 |
| 1518415736 | Kubei Holdings Group LLC | Case Management | 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 | 2016-09-16 |
| 1285087072 | Adrian Jung | Occupational Therapist | 155 Radio Drive, Woodbury, MN 55125 | 2016-07-18 |
| Find all providers in zip 55125 | ||||
| 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 |
|---|---|---|---|---|
| 1730711540 | Bailey Luna | Specialist/Technologist | 10712 Ironwood Ct, Woodbury, MN 55129-5811 | 2020-02-10 |
| 1194389833 | Vanoella Fru Shinwen | Specialist/Technologist | 2509 Cobble Hill Ct Unit J, Woodbury, MN 55125-4032 | 2019-04-29 |
| 1477011344 | Brianna Jankauskas | Specialist/Technologist | 568 N Evergreen Ave Apt C7, Woodbury, NJ 08096-1832 | 2019-03-08 |
| 1275043028 | Stephanie Alexandra Mckeen | Specialist/Technologist | 10611 Golden Eagle Trl, Woodbury, MN 55129-4280 | 2017-10-06 |
| 1427577063 | Sarah Ann Miller | Specialist/Technologist | 155 Inwood Drive, Woodbury, MN 55787 | 2017-09-14 |
| 1922453281 | Lauren Beek | Specialist/Technologist | 246 Plainview Rd, Woodbury, NY 11797-2807 | 2016-04-24 |
| 1528468550 | Alisa Jensen | Specialist/Technologist | 2090 Woodwinds Dr Ste 150, Woodbury, MN 55125-2522 | 2014-08-27 |
| 1558604181 | Melissa J Bowers | Specialist/Technologist | 1860 Wooddale Dr Ste 100, Woodbury, MN 55125-1947 | 2013-04-02 |
| 1801949953 | Melody A Arno | Specialist/Technologist | 25 N Broad St, Woodbury, NJ 08096-4602 | 2007-01-20 |
| 1225049588 | Debra Andruschkevich | Specialist/Technologist | 575 Fox Run Rd, Woodbury, NJ 08096-4242 | 2006-08-11 |
| Find all providers in WOODBURY | ||||
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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.