AMANDA SHADLE (NPI# 1881193217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881193217 |
| Entity Type | Individual |
| Full Name | AMANDA SHADLE |
| Practice Address |
1201 Grampian Blvd Williamsport PA 17701-1900 |
| Practice Telephone | 5703212020 |
| Practice Fax Number | 5703207599 |
| Mailing Telephone | 5703212020 |
| Mailing Fax Number | 5703207599 |
| Enumeration Date | 2018-02-12 |
| Last Update Date | 2018-02-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
RTO000318 | PA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1201 GRAMPIAN BLVD |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701-1900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942293287 | Joanne Marie Lalli | Internal Medicine | 1201 Grampian Blvd, Ste 2d, Williamsport, PA 17701 | 2005-08-23 |
| 1205436987 | Nicholas Anthony Inverso II | Pharmacist | 1201 Grampian Blvd, Williamsport, PA 17701-1900 | 2020-10-30 |
| 1629528385 | Brian Kramer Jr. | Physician Assistant | 1201 Grampian Blvd, Suite 1a, Williamsport, PA 17701-1900 | 2016-10-06 |
| 1326498726 | Morgan Rogers | Family Medicine | 1201 Grampian Blvd, Suite 3c, Williamsport, PA 17701-1970 | 2016-06-16 |
| 1528424975 | Ncpdc Kidney Center LLC | Clinic/Center | 1201 Grampian Blvd, Williamsport, PA 17701-1900 | 2016-01-14 |
| 1710369467 | North Central Pennsylvania Dialysis Clincs LLC | Clinic/Center | 1201 Grampian Blvd, Williamsport, PA 17701-1900 | 2015-06-18 |
| 1124315320 | Christine Kara Nolan | Podiatrist | 1201 Grampian Blvd, Suite 2f, Williamsport, PA 17701-1965 | 2011-07-08 |
| 1013228857 | Steven Michael Hawley | Podiatrist | 1201 Grampian Blvd, Suite 2f, Williamsport, PA 17701-1965 | 2010-06-26 |
| 1578791497 | Zachary Thomas Ritter | Podiatrist | 1201 Grampian Blvd, Suite 2f, Williamsport, PA 17701-1965 | 2009-06-30 |
| 1396970547 | Susquehanna Physician Services | Nurse Practitioner | 1201 Grampian Blvd, Suite 2e, Williamsport, PA 17701-1966 | 2009-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184267809 | Charlene Angella Pitter | Nurse Practitioner | 170 Warren Ave, Williamsport, PA 17701 | 2019-10-25 |
| 1396395299 | Susan E Fetzer | Occupational Therapy Assistant | Upmc Susquehanna,625 West Edwin Street, Williamsport, PA 17701 | 2019-09-13 |
| 1184280984 | Craig Andrew Tuller | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency, 740 High Street, Suite 4001, Williamsport, PA 17701 | 2019-05-16 |
| 1760048045 | Michael Harvey | Student in an Organized Health Care Education/Training Program | 740 High St. Suite 4001, Williamsport, PA 17701 | 2019-05-13 |
| 1275196008 | Olivia Fladmark | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency 740 High St, Suite 4001, Williamsport, PA 17701 | 2019-04-17 |
| 1528551231 | Mark Hampton Chiropractic Inc. | Durable Medical Equipment & Medical Supplies | 1111 East 3rd Street, Williamsport, PA 17701 | 2018-06-08 |
| 1548710882 | Central Pennsylvania Rehabilitation Medicine, Inc | Physical Medicine & Rehabilitation | 460 River Ave Ste 1, Williamsport, PA 17701 | 2016-10-11 |
| 1376096784 | Christine Kessler | Physician Assistant | One College Ave, Penna. College of Tech, Pa Program Dif 123, Williamsport, PA 17701 | 2016-08-02 |
| 1629440276 | Matthew Ray Rebuck | Specialist/Technologist | 220 N Reach Rd, Williamsport, PA 17701 | 2015-10-22 |
| 1508237223 | Neihl Williamson | Physician Assistant | 1205 Grampian Blvd Ste 3c, Williamsport, PA 17701 | 2015-10-08 |
| Find all providers in zip 17701 | ||||
| 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 |
|---|---|---|---|---|
| 1003357336 | Keri Moriarity | Specialist/Technologist | 700 College Pl, Box 143, Williamsport, PA 17701-5157 | 2017-03-20 |
| 1710438742 | Derrick Winters | Specialist/Technologist | 1347 Catherine St, Williamsport, PA 17701-2513 | 2016-10-14 |
| 1639522584 | Samantha Rae Miller | Specialist/Technologist | 335 Rural Ave, Williamsport, PA 17701-3340 | 2016-07-15 |
| 1629440276 | Matthew Ray Rebuck | Specialist/Technologist | 220 N Reach Rd, Williamsport, PA 17701 | 2015-10-22 |
| 1386049591 | Chad Woodside | Specialist/Technologist | 21 Huffman St, Williamsport, PA 17701-2157 | 2014-10-30 |
| 1992835623 | Brandyn Shane Charlton | Specialist/Technologist | 700 College Place, Lycoming College, Williamsport, PA 17701-5192 | 2007-03-06 |
| 1992834808 | Melissa Anne Loudenslager | Specialist/Technologist | 2990 W 4th St, Williamsport, PA 17701-9134 | 2007-03-05 |
| 1346384948 | Katie M Greene | Specialist/Technologist | 1 College Ave, Dif 38, Williamsport, PA 17701-5778 | 2007-02-16 |
| 1619059193 | Carmen Marie Terry | Specialist/Technologist | 1701 Grampian Blvd, Williamsport, PA 17701 | 2006-10-20 |
| 1114563111 | Andrea Lucas | Specialist/Technologist | 1 College Ave, Williamsport, PA 17701-5778 | 2019-11-25 |
| Find all providers in WILLIAMSPORT | ||||
| City | WILLIAMSPORT |
| Zip Code | 17701 |
Please comment or provide details below to improve the information on AMANDA SHADLE.
| 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.