MR. MATTHEW RYAN ROESER (NPI# 1639214406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639214406 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW RYAN ROESER |
| Credential | MA,ATC |
| Practice Address |
24715 Little Mack Ave Ste 100 Saint Clair Shores MI 48080-3207 |
| Mailing Address |
52799 Coulter Ct New Baltimore MI 48047-6504 |
| Practice Telephone | 5867797970 |
| Mailing Telephone | 5867165276 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| 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 |
24715 LITTLE MACK AVE STE 100 |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48080-3207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679500284 | Alexander Ajlouni | Anesthesiology | 24715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080 | 2006-06-27 |
| 1508410168 | Associated Orthopedists of Detroit PC | Clinic/Center | 24715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-3207 | 2019-07-31 |
| 1730646696 | Maren Bahra | Physician Assistant | 24715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-3207 | 2019-02-27 |
| 1821597659 | Advance Spine & Pain | Pain Medicine | 24715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-3207 | 2018-02-07 |
| 1275041188 | Bryan Krall | Physical Therapist | 24715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-3207 | 2018-01-12 |
| 1881107738 | Meghan Elizabeth Gallagher | Nurse Practitioner | 24715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-3207 | 2017-11-14 |
| 1780104711 | Scott Wade | Physical Therapist | 24715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080 | 2017-06-21 |
| 1124368923 | Jonathon Hinz | Orthopaedic Surgery | 24715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080 | 2013-02-15 |
| 1295971539 | James Storhok | Physical Therapist | 24715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-3207 | 2008-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508482084 | Farrah Aleema Rajab | Family Medicine | 24911 Little Mack Avenue, Suite C, St. Clair Shores, MI 48080 | 2020-06-22 |
| 1558986141 | Julia Anastazja Krakowska | Family Medicine | 24911 Little Mack, Suite C, St. Clair Shores, MI 48080 | 2020-06-10 |
| 1972073567 | Joyce Stepnak | Social Worker | 19611 E. 8 Mile Rd, Scs, MI 48080 | 2018-11-27 |
| 1487134177 | Bonnie Girson | Social Worker | 23409 Jefferson Ave Ste 100, Saint Clair Shores, MI 48080 | 2018-08-21 |
| 1609309913 | Park Pharmacy Scs LLC | Pharmacy | 20225 E 9 Mile Rd Ste 120a, Saint Clair Shores, MI 48080 | 2017-04-05 |
| 1730564055 | Mary Rose Giroux | Psychologist | 22516 Overlake St, St. Clair Shores, MI 48080 | 2015-07-28 |
| 1962882910 | Ali Tarif Bazzy | Family Medicine | 20225 E 9 Mile Rd Ste A, Saint Clair Shores, MI 48080 | 2015-06-04 |
| 1497156228 | Kelly Zalewski | Social Worker | 24631 Jefferson Ave, Saint Clair Shores, MI 48080 | 2014-09-11 |
| 1669871364 | Mallory Margret Gordon | Psychologist | 19900 E. 10 Mile Rd., Ste. 102, Saint Clair Shores, MI 48080 | 2014-08-19 |
| 1932549375 | Alexander Peter Bill | Otolaryngology | 22631 Greater Mack Ave Ste 200, Saint Clair Shores, MI 48080 | 2013-06-30 |
| Find all providers in zip 48080 | ||||
| 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 |
|---|---|---|---|---|
| 1093368573 | Jessica Scharffe | Specialist/Technologist | 22007 Centennial St, Saint Clair Shores, MI 48081-2837 | 2019-07-23 |
| 1952866717 | Emily Haas | Specialist/Technologist | 21824 Statler St, Saint Clair Shores, MI 48081-3747 | 2019-02-06 |
| 1407227689 | Elizabeth Landa | Specialist/Technologist | 20952 E 12 Mile Rd Ste 110, Saint Clair Shores, MI 48081-3202 | 2015-10-13 |
| 1881971562 | Rochelle Obloy Mazurek | Specialist/Technologist | 20952 E 12 Mile Rd Ste 110, Saint Clair Shores, MI 48081-3202 | 2011-11-09 |
| 1528188570 | Nicole Marie Zarucki | Specialist/Technologist | 20952 E 12 Mile Rd, Suite 110, Saint Clair Shores, MI 48081-3200 | 2007-03-30 |
| 1972641488 | David Philbrick | Specialist/Technologist | 20952 E 12 Mile Rd, Suite 110, Saint Clair Shores, MI 48081-3200 | 2007-02-05 |
| 1104916501 | Cassandra Denise Robinson | Specialist/Technologist | 20952 E 12 Mile Rd, Suite 110, Saint Clair Shores, MI 48081-3200 | 2006-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467052027 | Brianna Redmond | Specialist/Technologist | 2145 Sunset Ln, Saginaw, MI 48604-2443 | 2020-10-31 |
| 1386243913 | Carrie A Lindsay | Specialist/Technologist | 4761 Highland Rd, Waterford, MI 48328-1178 | 2020-10-24 |
| 1528667128 | Bethany Lynn York | Specialist/Technologist | 1461 Crest Rd, Gladwin, MI 48624-7606 | 2020-10-23 |
| 1255930962 | Benjamin Foddrill | Specialist/Technologist | 7380 Clearview Dr, Caledonia, MI 49316-9309 | 2020-10-22 |
| 1427656040 | Travis Zaborowski | Specialist/Technologist | 2412 W 4th Ave, Sault Sainte Marie, MI 49783-1212 | 2020-10-15 |
| 1730787912 | Batoul Kassem | Specialist/Technologist | 6045 Steadman St, Dearborn, MI 48126-2052 | 2020-10-11 |
| 1801493697 | Janelle Dorsey | Specialist/Technologist | 24311 Ithaca St, Oak Park, MI 48237-1788 | 2020-10-05 |
| 1194332379 | Bryan Keith Baines Sr. | Specialist/Technologist | 4333 John R Rd, Troy, MI 48085-3681 | 2020-09-30 |
| 1205443553 | Emma Weber | Specialist/Technologist | 7776 Percheron St, Kalamazoo, MI 49009-5990 | 2020-09-29 |
| 1295342616 | Margaret Ann Gilbeau | Specialist/Technologist | 38051 Metro Villa Dr Unit 114f, Harrison Township, MI 48045-3553 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48080 |
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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.