MRS. LISA MARIE BOBERG (NPI# 1629512124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629512124 |
| Entity Type | Individual |
| Full Name | MRS. LISA MARIE BOBERG |
| Credential | ATC |
| Practice Address |
8100 Northland Dr Bloomington MN 55431-4800 |
| Mailing Address |
7105 Riverview Ter Ne Fridley MN 55432-3046 |
| Practice Telephone | 9528318742 |
| Mailing Telephone | 6083328400 |
| Enumeration Date | 2016-12-19 |
| Last Update Date | 2016-12-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2053 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
8100 NORTHLAND DR |
| City | BLOOMINGTON |
| State | MN |
| Zip Code | 55431-4800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780150946 | Dillon Bruxvoort | Specialist/Technologist | 8100 Northland Dr, Bloomington, MN 55431-4800 | 2018-10-15 |
| 1619452026 | Julia Mcbrien | Occupational Therapist | 8100 Northland Dr, Bloomington, MN 55431 | 2018-10-02 |
| 1821508433 | Adam Jansen | Occupational Therapist | 8100 Northland Dr, Bloomington, MN 55431-4800 | 2017-10-09 |
| 1184148017 | Andrew Jacob Olson | Neuromusculoskeletal Medicine, Sports Medicine | 8100 Northland Dr, Bloomington, MN 55431-4800 | 2017-08-02 |
| 1831629849 | Brianna Marie Bosma | Physical Therapist | 8100 Northland Dr, Bloomington, MN 55431-4800 | 2017-06-13 |
| 1740720283 | Joshua Michael Brodersen | Specialist/Technologist | 8100 Northland Dr, Bloomington, MN 55431-4800 | 2017-03-02 |
| 1518411776 | Amy Haynes | Physical Therapist | 8100 Northland Dr, Bloomington, MN 55431-4800 | 2016-08-04 |
| 1659731222 | Connor Roach | Occupational Therapist | 8100 Northland Dr, Bloomington, MN 55431-4800 | 2016-02-25 |
| 1659744043 | Aimee Custer | Clinical Neuropsychologist | 8100 Northland Dr, Bloomington, MN 55431-4800 | 2015-11-05 |
| 1295111979 | Andrea Vavra | Specialist/Technologist | 8100 Northland Dr, Bloomington, MN 55431-4800 | 2015-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162509 | Mckenzie Mcadaragh | Nurse Practitioner | 10924 Girard Curve, Bloomington, MN 55431 | 2020-10-21 |
| 1760042253 | Adams Health Care Services, LLC | Registered Nurse | 10036 Washburn Ave S, Bloomington, MN 55431 | 2019-06-17 |
| 1851864755 | Hope Autism Center | Day Training, Developmentally Disabled Services | 9333 Penn Ave S, Bloomington, MN 55431 | 2019-01-03 |
| 1275006215 | Cameron Lee Small | Counselor | 9156 Vincent Ave S, Bloomington, MN 55431 | 2019-01-02 |
| 1497240469 | Mikayla Slegh | Behavior Technician | 8200 Humboldt Ave S Suite 100, Bloomington, MN 55431 | 2018-06-22 |
| 1073061552 | David Wells | Nurse Practitioner | 8100 Northland Dr., Bloomington, MN 55431 | 2016-09-14 |
| 1780033076 | Yasin Jama | Contractor | 9810 Drew Avenue South, Apartment 106, Bloomington, MN 55431 | 2016-06-07 |
| 1972961001 | Kadar Hadis | Social Worker | 8200 Humboldt Ave S Ste 217, Bloomington, MN 55431 | 2016-02-03 |
| 1063878908 | Amazing Transportation Services, LLC | Non-emergency Medical Transport (VAN) | 9031 Penn Ave South Suite 100, Bloomington, MN 55431 | 2016-01-07 |
| 1093170136 | Kelsey Margaret Perreault | Chiropractor | 8120 Penn Ave. S., Suite 525, Bloomington, MN 55431 | 2015-12-16 |
| Find all providers in zip 55431 | ||||
| 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 |
|---|---|---|---|---|
| 1770110967 | Erica Zemites | Specialist/Technologist | 20 Brickyard Dr Apt A18, Bloomington, IL 61701-7085 | 2020-03-26 |
| 1083257547 | Ava Korinke | Specialist/Technologist | 701 E 17th St, Bloomington, IN 47408-1578 | 2019-10-28 |
| 1760025308 | Kyle Robert Barr | Specialist/Technologist | 1428 S Washington St, Bloomington, IN 47401-5878 | 2019-10-28 |
| 1497398028 | James Aaron Dash | Specialist/Technologist | 1419 W Allen St, Bloomington, IN 47403-2930 | 2019-10-27 |
| 1225671852 | Sierra Johnson | Specialist/Technologist | 2036 N Walnut St Apt 7, Bloomington, IN 47404-2465 | 2019-10-27 |
| 1285284158 | Keisuke Kawata | Specialist/Technologist | 1025 E 7th St # C215, Bloomington, IN 47405-7109 | 2019-09-12 |
| 1205485877 | Susan Marie Bitney | Specialist/Technologist | 10217 Scarborough Rd, Bloomington, MN 55437-2516 | 2019-09-06 |
| 1912566092 | Matthew Wayne Adams | Specialist/Technologist | 2301 E Arden Dr, Bloomington, IN 47401-6890 | 2019-06-11 |
| 1356806384 | Tori J Eastes | Specialist/Technologist | 1150 S Clarizz Blvd, Bloomington, IN 47401-4270 | 2019-02-04 |
| 1689139602 | Hallie Mccarn | Specialist/Technologist | 503 S Muller Pkwy Apt 303, Bloomington, IN 47403-1635 | 2019-02-04 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 55431 |
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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.