MR. DAVE MARELL FAIRLEY (NPI# 1932137221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932137221 |
| Entity Type | Individual |
| Full Name | MR. DAVE MARELL FAIRLEY |
| Credential | RKT |
| Practice Address |
1030 Jefferson Ave Memphis TN 38104-2127 |
| Mailing Address |
1309 Greenbrook Bnd Apt 2 Memphis TN 38134-8696 |
| Practice Telephone | 9015238990 |
| Practice Fax Number | 9015777459 |
| Mailing Telephone | 9013405498 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 226300000X | Kinesiotherapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1030 JEFFERSON AVE |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104-2127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982697025 | Katherine Denton Sanford | Optometrist | 1030 Jefferson Ave, Mail Code 112d, Memphis, TN 38104-2127 | 2005-08-24 |
| 1528667938 | Mckenzie Bahl | Recreation Therapist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-10-19 |
| 1427656834 | Phillip David Resuggan | Music Therapist | 1030 Jefferson Ave, Memphis, TN 38104-2193 | 2020-10-16 |
| 1962009159 | Rachel Diann Roberts | Nurse Anesthetist, Certified Registered | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-10-01 |
| 1225643018 | Melanie Warren | Nurse Practitioner | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-09-09 |
| 1942828892 | Brady Cole | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-07-08 |
| 1457978595 | Mariko Thel | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-07-05 |
| 1215554910 | Weston Paul Keen | Pharmacy | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-29 |
| 1225655236 | Rebecca Fong | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-26 |
| 1225653660 | Brandy Hollums | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
| 1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
| 1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
| 1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
| 1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
| 1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
| 1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
| 1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
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| Taxonomy Code | 226300000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Kinesiotherapist |
| A provider trained and educated in the applied science of medically prescribed therapeutic exercise, education and adapted physical activities designed to improve the quality of line and health of adults and children by developing physical fitness, increasing mobility and independence, and improving psychosocial behavior. The kinesiotherapist seeks a coach-player relationship in which he/she helps the patient/client reach the goal of becoming an independent, self-sustaining person. Kinesiotherapists, as compared with physical therapists, put more emphasis on geriatric care, reconditioning and fitness, and psychiatric care. A large percentage of kinesiotherapists practice in Veterans Administration hospitals. |
| Notes: Source: The Kinesiotherapy Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639606999 | Stevenson Mckinney | Kinesiotherapist | 1030 Jefferson Ave # 117kt, Memphis, TN 38104-2127 | 2017-05-17 |
| 1831120625 | Winfred Bernard Abrams | Kinesiotherapist | 584 Dreger Rd, Memphis, TN 38109-8365 | 2006-07-06 |
| 1558387233 | Wanda Anita Johnson | Kinesiotherapist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2006-07-14 |
| 1134157977 | Lester Richard | Kinesiotherapist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2006-06-29 |
| 1376571760 | Tammy T Williams | Kinesiotherapist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2006-06-28 |
| 1124054622 | Regina G. Echols | Kinesiotherapist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2006-06-25 |
| 1649215781 | Bryan J Garrison | Kinesiotherapist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558571992 | Doretha Staples | Kinesiotherapist | 9216 Ina Cv, Bartlett, TN 38133-0914 | 2007-05-23 |
| 1962502609 | Michael D Kuziola | Kinesiotherapist | Bldg 200 Sydney and Lamont, Mountain Home, TN 37684 | 2006-09-23 |
| 1790725414 | Richard Keith Smithdeal | Kinesiotherapist | James Quillen Vamc, Bld 200 Rms(117), Moutain Home, TN 37684 | 2006-06-08 |
| 1467000158 | Brennan Barlow | Kinesiotherapist | 3400 Lebanon Rd, Murfreesboro, TN 37129-1392 | 2019-08-27 |
| 1659838068 | Tammy A Roberts | Kinesiotherapist | 3400 Lebanon Pike, Murfreesboro, TN 37129 | 2019-02-22 |
| 1871091470 | John Kenneth Purvis | Kinesiotherapist | 3400 Lebanon Rd, Murfreesboro, TN 37129-1392 | 2018-01-29 |
| 1922438340 | Brian Hudson | Kinesiotherapist | 3400 Lebanon Pike, Murfreesboro, TN 37129 | 2013-11-21 |
| 1023396470 | John Kleamenakis | Kinesiotherapist | 3400 Lebanon Rd, Murfreesboro, TN 37129-1237 | 2011-08-02 |
| 1093954364 | Craig Phillip Gobich | Kinesiotherapist | 3400 Lebanon Rd, Murfreesboro, TN 37129-1237 | 2009-02-10 |
| 1134247547 | Robert Franklin Potter | Kinesiotherapist | Department of Veterans Affairs, James H. Quillen Va Medical Center, Mountain Home, TN 37684 | 2007-03-26 |
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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.