SOPHIA DIANE BELLAVISTA (NPI# 1760973572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760973572 |
| Entity Type | Individual |
| Full Name | SOPHIA DIANE BELLAVISTA |
| Credential | LAT, ATC |
| Practice Address |
100 Executive Way Ste 109 Ponte Vedra Beach FL 32082-2713 |
| Mailing Address |
43 Primrose Ln Palm Coast FL 32164-7416 |
| Practice Telephone | 9045439011 |
| Mailing Telephone | 9046690020 |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2018-05-29 |
| Gender Code | F |
| 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 |
100 EXECUTIVE WAY STE 109 |
| City | PONTE VEDRA BEACH |
| State | FL |
| Zip Code | 32082-2713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528582921 | Megan Vaughn Belanger | Specialist/Technologist | 100 Executive Way Ste 109, Ponte Vedra Beach, FL 32082-2713 | 2017-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518576818 | Specialty Eye Surgeons, Pa | Ophthalmology | 240 Ponte Vedra Boulevard, Suite 202, Ponte Vedra Beach, FL 32082 | 2020-07-23 |
| 1649820630 | Ponte Vedra Endodontics | Dentist | 822 A1a North, Ste 314, Ponte Vedra Beach, FL 32082 | 2019-09-12 |
| 1568988129 | Mustafa Bakir | General Practice | 1102 A1a, Ponte Vedra Beach, FL 32082 | 2017-08-16 |
| 1457890584 | Angelyn Sorgen | Nurse Practitioner | 1102 Hwy A1a, Suite 104, Ponte Vedra Beach, FL 32082 | 2017-02-22 |
| 1033575121 | Balanced Physician Care Pa | Family Medicine | 115 Professional Park Drive, Suite 104, Ponte Vedra Beach, FL 32082 | 2016-01-06 |
| 1528436060 | Robert Thompson II | Chiropractor | 135 Professional Drive, Suite 105, Ponte Vedra Beach, FL 32082 | 2015-09-14 |
| 1144628439 | Integrative Medical Group, Usa, LLC | Clinic/Center | 1102 A1a North, Suite 104, Ponte Vedra Beach, FL 32082 | 2014-12-18 |
| 1811308901 | Janice Wachtel, Phd, LLC | Psychologist | 100 Executive Way, Suite 110, Ponte Vedra Beach, FL 32082 | 2014-05-12 |
| 1578991154 | Nicole Theiler | Counselor | 171 Canal Blvd, Ponte Vedra Beach, FL 32082 | 2013-10-17 |
| 1982948006 | Daisamma Varghese | Nurse Practitioner | 860 A1an, Ponte Vedra, FL 32082 | 2012-11-15 |
| Find all providers in zip 32082 | ||||
| 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 |
|---|---|---|---|---|
| 1043862949 | Anna Swan | Specialist/Technologist | 227 Pablo Rd, Ponte Vedra Beach, FL 32082-1804 | 2019-07-10 |
| 1437654597 | Matthew Bryan Wander | Specialist/Technologist | 122 Oak View Cir, Ponte Vedra Beach, FL 32082-2645 | 2018-03-29 |
| 1528582921 | Megan Vaughn Belanger | Specialist/Technologist | 100 Executive Way Ste 109, Ponte Vedra Beach, FL 32082-2713 | 2017-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811597560 | Hannah Ogle | Specialist/Technologist | 110 Gloria Drive, Hollister, FL 32147 | 2020-10-30 |
| 1740889377 | Ryan Michael Hill | Specialist/Technologist | 314 S Habana Ave, Tampa, FL 33609-3223 | 2020-10-24 |
| 1568061182 | Lester Vivian Leon Ferdinand | Specialist/Technologist | 6705 S Red Rd Ste 410, South Miami, FL 33143-3644 | 2020-10-24 |
| 1770182651 | Sarah Danielle Combs | Specialist/Technologist | 4521 Lenmore Street, Orlando, FL 32812 | 2020-10-21 |
| 1679170369 | David S Duchin | Specialist/Technologist | 19033 Nw 23rd Ct, Pembroke Pines, FL 33029-5337 | 2020-10-06 |
| 1750988838 | Jade Shields | Specialist/Technologist | 144 Enrede Ln, Saint Augustine, FL 32095-7436 | 2020-10-02 |
| 1639786940 | Dewayne N Dubose | Specialist/Technologist | 344 Chesham St, Ormond Beach, FL 32174-0692 | 2020-09-30 |
| 1467069914 | Alison M Dougan | Specialist/Technologist | 3345 Cypress Legends Cir Apt 1104, Fort Myers, FL 33905-5542 | 2020-09-29 |
| 1225643240 | Megan Marisa Fox | Specialist/Technologist | 5803 Marta Dr, Tampa, FL 33617-1125 | 2020-09-15 |
| 1104430305 | Nikki Page Keown | Specialist/Technologist | 12136 Luftburrow Ln, Hudson, FL 34669-5005 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
| City | PONTE VEDRA BEACH |
| Zip Code | 32082 |
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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.