JUSTIN ULLOM (NPI# 1538626007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538626007 |
| Entity Type | Individual |
| Full Name | JUSTIN ULLOM |
| Practice Address |
1111 Victor St Saint Louis MO 63104-4323 |
| Mailing Address |
1911 S 11th St Apt C Saint Louis MO 63104-4089 |
| Practice Telephone | 6362365756 |
| Mailing Telephone | 6362365756 |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2020-04-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2020008148 | MO | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1111 VICTOR ST |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63104-4323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
| 1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
| 1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
| 1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
| 1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
| 1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
| 1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
| 1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
| 1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
| 1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
| Find all providers in zip 63104 | ||||
| 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 |
|---|---|---|---|---|
| 1265039192 | Carley M Swabby | Specialist/Technologist | 652 Bismark Ave, Saint Louis, MO 63119-1528 | 2020-10-05 |
| 1194383943 | Elizabeth Lynch | Specialist/Technologist | 605 Clara Ave Apt 609, Saint Louis, MO 63112-1936 | 2019-06-05 |
| 1063970242 | Abby Hoffman | Specialist/Technologist | 7318 Brunswick Ave, Saint Louis, MO 63119-3329 | 2019-03-07 |
| 1649738824 | Emma C Yonkers | Specialist/Technologist | 4050 W Pine Blvd Apt 3207, Saint Louis, MO 63108-3349 | 2019-03-07 |
| 1386102556 | Justin Durham | Specialist/Technologist | 8425 Engler Ave, Saint Louis, MO 63114-4126 | 2019-03-06 |
| 1003373564 | Brian Tyler Leach | Specialist/Technologist | 6120 Wanda Ave, Saint Louis, MO 63116-2225 | 2019-02-20 |
| 1003372566 | Jesse Schmitt | Specialist/Technologist | 3939 W Pine Blvd, Saint Louis, MO 63108-3220 | 2019-02-20 |
| 1326504846 | Breanna Kenney | Specialist/Technologist | 1024 Colebrook Dr, Saint Louis, MO 63119-4757 | 2019-02-20 |
| 1083170518 | Paul Samuel Lamb | Specialist/Technologist | 3805 Lindell Blvd Apt A, Saint Louis, MO 63108-3451 | 2019-02-20 |
| 1215406210 | Emily Kingston Karleskint | Specialist/Technologist | 7492 Ahern Ct, Saint Louis, MO 63130-2218 | 2018-11-19 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63104 |
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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.