OA ASSOCIATED LLC (NPI# 1699061259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699061259 |
| Entity Type | Organization |
| Organization Name | OA ASSOCIATED LLC |
| Other Organization Name | SOUTHERN ILLINOIS SPORTS MEDICINE |
| Practice Address |
4550 Memorial Dr Moc-1, Suite G-100 Belleville IL 62226-5372 |
| Practice Telephone | 6182362246 |
| Practice Fax Number | 6182362315 |
| Mailing Telephone | 6182362246 |
| Mailing Fax Number | 6182362315 |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2011-06-22 |
| Authorized Official Name | JASON DANIEL NOELDNER (ATHLETIC TRAINER) |
| Authorized Official Telephone | 6182362246 |
| Authorized Official Credential | ATC,LAT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
096002594 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| Southern Illinois Sports Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639692973 | Oa Associated LLC | Orthopaedic Surgery | 1414 Cross St Ste 110, Shiloh, IL 62269-2988 | 2017-07-19 |
| Street Address |
4550 MEMORIAL DR MOC-1, SUITE G-100 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-5372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427055961 | Lawrence Mcclinton | Physician Assistant | 4550 Memorial Dr, Ste. 280, Belleville, IL 62226-5372 | 2005-06-30 |
| 1902273717 | Tammi Lynn Jones | Nurse Practitioner | 4550 Memorial Dr, Suite 360, Belleville, IL 62226-5372 | 2015-08-27 |
| 1235474057 | Memorial Medical Group, LLC | Anesthesiology | 4550 Memorial Dr, Ste. 340, Belleville, IL 62226-5372 | 2012-12-05 |
| 1013265248 | Deanna L. Rodenberg | Registered Nurse | 4550 Memorial Dr, Ste. 340, Belleville, IL 62226-5372 | 2012-08-20 |
| 1619260932 | Dori Hunt | Nurse Practitioner | 4550 Memorial Dr, Ste. 340, Belleville, IL 62226-5372 | 2011-05-19 |
| 1821302118 | Pc Associates, LLC | Hospitalist | 4550 Memorial Dr, Suite 340, Belleville, IL 62226-5372 | 2010-07-29 |
| 1386958668 | Pc Associates, LLC | Family Medicine | 4550 Memorial Dr, Ste 180, Belleville, IL 62226-5372 | 2010-07-29 |
| 1376857656 | Ca Group, LLC | Internal Medicine | 4550 Memorial Dr, Ste 310, Belleville, IL 62226-5372 | 2010-07-29 |
| 1649584921 | Ca Group LLC | Internal Medicine | 4550 Memorial Dr, Suite 320, Belleville, IL 62226-5372 | 2010-07-29 |
| 1295049666 | Msa Alliance, LLC | Urology | 4550 Memorial Dr, Ste 350, Belleville, IL 62226-5372 | 2010-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| 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 |
|---|---|---|---|---|
| 1588131767 | Ezekiel Joubert Jr. | Specialist/Technologist | 24261 Elwell Rd, Belleville, MI 48111-9412 | 2018-10-25 |
| 1033607403 | Lindsey Caroline Woller | Specialist/Technologist | 7161 Frenchtown Rd, Belleville, WI 53508-9530 | 2018-05-01 |
| 1649710419 | Frank M. Aiello | Specialist/Technologist | 68 Emmet St, Belleville, NJ 07109-2315 | 2017-02-27 |
| 1124487137 | Dani Collins | Specialist/Technologist | 212 S Virginia Ave, Belleville, IL 62220-3883 | 2016-02-18 |
| 1962871558 | Antony Frierdich | Specialist/Technologist | 22 South 13th Street, Belleville, IL 62220 | 2015-09-24 |
| 1275915712 | Jason Patrick Williams | Specialist/Technologist | 11225 Morton Taylor Rd, Belleville, MI 48111-1330 | 2015-06-21 |
| 1619367505 | Aaron Kremmel | Specialist/Technologist | 105 Whiteside Dr, Belleville, IL 62221-2558 | 2015-01-29 |
| 1316233224 | Rodney Dean Ford Jr. | Specialist/Technologist | 4550 Memorial Dr. Office Center One Ste G100, Belleville, IL 62226-5372 | 2011-06-20 |
| 1528376191 | Marissa Radice | Specialist/Technologist | 17 Pleasant Ave, Belleville, NJ 07109-1329 | 2010-09-16 |
| 1083758528 | Cynthia Jo Bowers | Specialist/Technologist | 6452 Denton Rd, Belleville, MI 48111-1015 | 2007-02-17 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
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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.