SHANNON CLEGG (NPI# 1689050874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689050874 |
| Entity Type | Individual |
| Full Name | SHANNON CLEGG |
| Credential | MED, ATC, CES, PES |
| Practice Address |
1900 W Olney Ave Philadelphia PA 19141-1108 |
| Practice Telephone | 2159511519 |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2015-08-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
RT004086 | PA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1900 W OLNEY AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19141-1108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215990395 | Jasper Ayeni | Specialist/Technologist | 1900 W Olney Ave, Philadelphia, PA 19141-1108 | 2006-04-10 |
| 1568950178 | Lasalle University | Orthopaedic Surgery | 1900 W Olney Ave, Philadelphia, PA 19141-1108 | 2018-04-30 |
| 1558800771 | Jacob Bendixen | Specialist/Technologist | 1900 W Olney Ave, Philadelphia, PA 19141-1108 | 2017-02-21 |
| 1245779586 | Christine Gindhart | Specialist/Technologist | 1900 W Olney Ave, Philadelphia, PA 19141-1108 | 2017-02-20 |
| 1376908038 | William Gerzabek | Specialist/Technologist | 1900 W Olney Ave, Philadelphia, PA 19141-1108 | 2015-12-23 |
| 1548659378 | Nina Kauffman | Specialist/Technologist | 1900 W Olney Ave, Philadelphia, PA 19141-1108 | 2015-01-16 |
| 1174795983 | Abigail S Hamilton | Psychologist | 1900 W Olney Ave, Philadelphia, PA 19141-1108 | 2008-04-01 |
| 1942410709 | Sharon Metzler-ruth | Nurse Practitioner | 1900 W Olney Ave, Philadelphia, PA 19141-1108 | 2007-05-23 |
| 1578621058 | Andrea Z. Okagawa | Nurse Practitioner | 1900 W Olney Ave, Philadelphia, PA 19141-1108 | 2006-12-05 |
| 1881752434 | Dina M Oleksiak | Nurse Practitioner | 1900 W Olney Ave, Philadelphia, PA 19141-1108 | 2006-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598375925 | Meredith Jeanne Behr | Physician Assistant | 5401 N Broad St, Philadelphia, PA 19141 | 2020-07-31 |
| 1811552896 | Kristine Nissley | Registered Nurse | Einstein Urology Associates, 1200 West Tabor Road, 3rd Floor, Philadelphia, PA 19141 | 2019-05-06 |
| 1427525054 | Danielle Dicicco Havelin | Social Worker | 1314 Windrim Ave, Philadelphia, PA 19141 | 2018-11-01 |
| 1568956043 | Reid Thomas Alley | Psychiatry & Neurology | Albert Einstein Medical Center 5501 Old York Road, Philadelphia, PA 19141 | 2018-06-19 |
| 1912409533 | Lauren Joy Barton | Physician Assistant | 5401 N Broad St Ste 363, Philadelphia, PA 19141 | 2018-02-28 |
| 1952819633 | Einstein Practice Plan, Inc. | Internal Medicine | 5501 Old York Rd Fl Moss3, Philadelphia, PA 19141 | 2018-01-17 |
| 1043739642 | Lauren Lynn Pleis | Nurse Practitioner | 1200 Tabor Road, Philadelphia, PA 19141 | 2017-09-14 |
| 1225558224 | Ryan A. Hoffman | Student in an Organized Health Care Education/Training Program | Albert Einstein Medical Center, 5501 Old York Road, Philadelphia, PA 19141 | 2017-06-21 |
| 1972036515 | Hussein Safa | Family Medicine | 1300 W Tabor Rd Bldg 1, Philadelphia, PA 19141 | 2017-04-11 |
| 1366895500 | Ejaz Mahmood | Student in an Organized Health Care Education/Training Program | 5501, Old York Road, Albert Einstein Medical Centre, Philadelphia, PA 19141 | 2016-07-22 |
| Find all providers in zip 19141 | ||||
| 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 |
|---|---|---|---|---|
| 1841891108 | Sydney Charles | Specialist/Technologist | 6325 Martins Mill Rd, Philadelphia, PA 19111-5321 | 2020-11-03 |
| 1114528684 | Kelsey E Craig | Specialist/Technologist | 1856 N 16th St Apt 1r, Philadelphia, PA 19121-3301 | 2020-11-02 |
| 1740881333 | David Williams | Specialist/Technologist | 3100 W Thompson St Apt 42, Philadelphia, PA 19121-4485 | 2020-11-02 |
| 1992305940 | Alexandra Bossi | Specialist/Technologist | 450 N 18th St Apt 1032, Philadelphia, PA 19130-4198 | 2020-10-29 |
| 1427661842 | Autumn Kelly | Specialist/Technologist | 3300 Henry Ave Apt 522, Philadelphia, PA 19129-1160 | 2020-08-25 |
| 1558984609 | Keri Lapinski | Specialist/Technologist | 929 N 6th St Apt 2, Philadelphia, PA 19123-1405 | 2020-05-24 |
| 1356975445 | Shaun Shields | Specialist/Technologist | 1814 N. Broad Street, Philadelphia, PA 19121 | 2020-02-27 |
| 1619500410 | Halie Ann Maria Hurtado | Specialist/Technologist | 1000 S Broad St Apt 833, Philadelphia, PA 19146-2261 | 2020-02-20 |
| 1215569561 | Danielle Quigley | Specialist/Technologist | 6903 Shalkop St, Philadelphia, PA 19128-3218 | 2020-02-05 |
| 1457982076 | Jacie Fabro | Specialist/Technologist | 4136 Mitchell St Apt 407, Philadelphia, PA 19128-3511 | 2020-02-02 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19141 |
Please comment or provide details below to improve the information on SHANNON CLEGG.
| 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.