EDISON DERR II (NPI# 1861873952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861873952 |
| Entity Type | Individual |
| Full Name | EDISON DERR II |
| Practice Address |
2214 Maple St Saint Joseph MO 64507-1413 |
| Practice Telephone | 4196512323 |
| Mailing Telephone | 4196512323 |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-06-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2013032471 | MO | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2214 MAPLE ST |
| City | SAINT JOSEPH |
| State | MO |
| Zip Code | 64507-1413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346644044 | Janaha Anderson | Dental Hygienist | 4073 Se Cunningham Rd, St. Joseph, MO 64507 | 2014-10-09 |
| 1518229772 | Andrew L Walker | Radiology | 902 N Riverside Rd Ste 201, Saint Joseph, MO 64507 | 2012-06-13 |
| 1619105731 | Pamela M. Lotz | Clinical Nurse Specialist | 902 No. Riverside Rd, Suite 200, St. Joseph, MO 64507 | 2009-06-26 |
| 1356300735 | St Joseph Oncology Inc | Internal Medicine | 902 No Riverside Rd, Suite 200, St Joseph, MO 64507 | 2006-03-22 |
| 1962478560 | Douglas Chyatte | Neurological Surgery | 802 N Riverside Rd Ste 120, Saint Joseph, MO 64507 | 2006-02-24 |
| 1073089546 | Chaz Caleb Johnson | Physical Therapist | 5506 Corporate Dr Ste 1800, Saint Joseph, MO 64507 | 2018-10-22 |
| 1295228344 | Julie Odonnell Phd LLC | Clinic/Center | 708 S Woodbine Rd Ste A, Saint Joseph, MO 64507 | 2018-06-13 |
| 1912369695 | Luke Nathan Prest | Pediatrics | 902 N Riverside Rd Ste 100, Saint Joseph, MO 64507 | 2016-03-22 |
| 1396007894 | Brian Wright Roe | Internal Medicine | 5514 Corporate Dr Ste 150, Saint Joseph, MO 64507 | 2012-06-11 |
| 1184740342 | Progressive Community Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2612 Doniphan Ave, Saint Joseph, MO 64507-1457 | 2007-03-21 |
| Find all providers in zip 64507 | ||||
| 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 |
|---|---|---|---|---|
| 1225592421 | Andrea Canas | Specialist/Technologist | 508 Sherwood Dr, Saint Joseph, IL 61873-9468 | 2019-01-22 |
| 1538661186 | Jesse Anderson | Specialist/Technologist | 102 Iverson St W, Saint Joseph, MN 56374-4650 | 2018-02-28 |
| 1437504594 | Jenna Beth Zettel | Specialist/Technologist | 5655 S 4th St, Saint Joseph, MO 64504-1708 | 2016-04-26 |
| 1861856403 | Hannah E Warnert | Specialist/Technologist | 33674 83rd Ave, Saint Joseph, MN 56374-9786 | 2016-04-10 |
| 1982074175 | Timothy Clair Mcnair | Specialist/Technologist | 1446 Deerfield St, Saint Joseph, MI 49085-9763 | 2015-09-30 |
| 1033586466 | Cara Conrad | Specialist/Technologist | 4367 Hart Dr, Saint Joseph, MI 49085-9310 | 2015-09-02 |
| 1992198014 | Madeline Svec | Specialist/Technologist | 3170 Estates Dr N, Saint Joseph, MI 49085-3435 | 2015-03-13 |
| 1174860944 | Blaise D. Kriley | Specialist/Technologist | 4525 Downs Dr, Saint Joseph, MO 64507-2246 | 2013-01-13 |
| 1306867049 | Mark Duane Russell | Specialist/Technologist | 3950 Hollywood Rd Ste 140, Saint Joseph, MI 49085-9151 | 2006-07-21 |
| 1588693311 | Kate Lee Esely | Specialist/Technologist | 5110 Mockingbird Ln, Saint Joseph, MO 64506-3331 | 2006-07-02 |
| Find all providers in SAINT JOSEPH | ||||
| City | SAINT JOSEPH |
| Zip Code | 64507 |
Please comment or provide details below to improve the information on EDISON DERR II.
| 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.