MS. ANNE MARIE MICINSKI (NPI# 1912065848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912065848 |
| Entity Type | Individual |
| Full Name | MS. ANNE MARIE MICINSKI |
| Credential | ATC, LAT |
| Practice Address |
1005 N Hickory Rd South Bend IN 46615-3723 |
| Mailing Address |
3718 Fern Hill Dr Mishawaka IN 46544-6265 |
| Practice Telephone | 5742335754 |
| Mailing Telephone | 5742578512 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
36000188A | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1005 N HICKORY RD |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46615-3723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912903063 | Francis J Mcdonald | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-3723 | 2005-06-23 |
| 1023656907 | Lauren Taylor | Physical Therapy Assistant | 1005 N Hickory Rd, South Bend, IN 46615-2280 | 2019-12-11 |
| 1720567167 | Jeana Marie Marren | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-2280 | 2018-08-07 |
| 1285112771 | Christopher Higgins | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-2280 | 2018-08-06 |
| 1568974087 | Jonathan Cultura | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-3723 | 2017-10-25 |
| 1922457274 | Mary Stoller | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-3723 | 2016-06-08 |
| 1245630656 | Kaes Kamman | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-3723 | 2014-09-04 |
| 1013339167 | Nicholas Bugbee | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-3723 | 2014-01-08 |
| 1639421746 | Matthew Leblang | Physical Therapist | 1005 N Hickory Rd, South Bend, IN 46615-3723 | 2012-10-12 |
| 1346524063 | Neringa Snyder | Physical Therapy Assistant | 1005 N Hickory Rd, South Bend, IN 46615-3723 | 2011-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679954804 | Healthlinc, Inc. | Clinic/Center | 1002 S Esther St, South Bend, IN 46615 | 2015-06-12 |
| 1861897688 | Michelle Jean Streb | Registered Nurse | 1960 Northside Boulevard, South Bend, IN 46615 | 2014-10-23 |
| 1275848962 | Charles Mikel Craig | Optometrist | 220 N. Ironwood Dr., South Bend, IN 46615 | 2010-08-18 |
| 1710219613 | Debra Vasquez | Occupational Therapy Assistant | 1950 Ridgedaleroad, South Bend, IN 46615 | 2010-02-03 |
| 1114259132 | Christopher Joseph Smith | Physical Therapist | 1005 Hickory Rd, South Bend, IN 46615 | 2010-02-01 |
| 1295064525 | Starlight Care Facilities, Inc | Skilled Nursing Facility | 915 So. 27th Street, South Bend, IN 46615 | 2009-12-16 |
| 1699002642 | Ann G Pryor | Contractor | 1516 E. Wayne St., South Bend, IN 46615 | 2009-11-12 |
| 1891917449 | Logan Community Resources, Inc. | Community/Behavioral Health | 2505 E. Jefferson Blvd, South Bend, IN 46615 | 2007-05-03 |
| 1487712683 | Julie Gaydos Plagens | Dentist | 604 South Eddy St, South Bend, IN 46615 | 2006-12-04 |
| 1629163084 | Edward F Klodzinski | Counselor | 3603 E. Jefferson Blvd., South Bend, IN 46615 | 2006-10-03 |
| Find all providers in zip 46615 | ||||
| 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 |
|---|---|---|---|---|
| 1043776321 | Nicholas B Hoover | Specialist/Technologist | 52695 Sporn Dr, South Bend, IN 46635-1228 | 2019-02-12 |
| 1053816439 | Anna Roberts | Specialist/Technologist | 453 N Notre Dame Ave, South Bend, IN 46617-2335 | 2018-03-27 |
| 1821517392 | Scott Flanagan | Specialist/Technologist | 50709 Marie Ct, South Bend, IN 46637-2317 | 2017-09-15 |
| 1740731116 | Jack Mcintyre Kimmell | Specialist/Technologist | 1526 East Lasalle, South Bend, IN 46617 | 2016-10-20 |
| 1518387216 | Kendra Weber | Specialist/Technologist | 904 Woodbine Way, South Bend, IN 46628-1241 | 2014-04-21 |
| 1336426139 | Kelly Demski | Specialist/Technologist | 52926 Red Fox Trl, South Bend, IN 46628-9247 | 2011-11-08 |
| 1194937680 | Sarah Elizabeth Redman | Specialist/Technologist | 53880 Carmichael Dr., South Bend, IN 46617 | 2007-05-04 |
| 1871623595 | Anthony Zorger | Specialist/Technologist | 808 S Twyckenham Dr, South Bend, IN 46615-1134 | 2007-03-06 |
| 1063057198 | Joseph Lawrence Carr | Specialist/Technologist | 808 S Twyckenham Dr, South Bend, IN 46615-1134 | 2019-11-13 |
| 1821639477 | Lauren M Burish | Specialist/Technologist | 111 W Jefferson Blvd Ste 100, South Bend, IN 46601-1993 | 2019-10-04 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46615 |
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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.