JILLIAN ANN HACKER (NPI# 1962989640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962989640 |
| Entity Type | Individual |
| Full Name | JILLIAN ANN HACKER |
| Credential | ATC |
| Practice Address |
3946 Ice Way Fort Wayne IN 46805-1018 |
| Mailing Address |
8813 Gulf Dr Apt B Fort Wayne IN 46825-3092 |
| Practice Telephone | 2604442788 |
| Mailing Telephone | 7655247455 |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2020-09-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
36003377A | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | INDIANA PROFESSIONAL LICENSING AGENCY | 36003377A | 01 |
| IN | BOC | 2000038863 | 01 |
| Street Address |
3946 ICE WAY |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-1018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619945888 | Beth Ann Herrell | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2006-03-14 |
| 1184263857 | Calvin Bissell | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46805-1018 | 2019-12-30 |
| 1639727068 | Briana Marie Wood | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46805-1018 | 2019-08-28 |
| 1215583703 | Lauren Elizabeth Ehle | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46805-1018 | 2019-08-12 |
| 1932767530 | Amanda Nicole Toney | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46805-1018 | 2019-05-30 |
| 1750851168 | Tyler Cheney | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-28 |
| 1487123550 | Michaela Mcguire | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-19 |
| 1861961088 | Olivia Marquardt | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-16 |
| 1184191652 | Lynn Marie Miller | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46805-1018 | 2018-11-01 |
| 1447753140 | Adam Gibson | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46805-1018 | 2018-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
| 1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
| 1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
| 1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
| Find all providers in zip 46805 | ||||
| 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 |
|---|---|---|---|---|
| 1699308700 | Jennifer N Peppler | Specialist/Technologist | 3434 Kirkfield Dr, Fort Wayne, IN 46815-5972 | 2020-02-17 |
| 1710519392 | Mitchell Mckay Enyart | Specialist/Technologist | 1617 Randford Pl, Fort Wayne, IN 46815-7635 | 2020-02-11 |
| 1003448671 | Chelsea L Harrison | Specialist/Technologist | 6716 Ramblewood Ct Apt L, Fort Wayne, IN 46835-1760 | 2020-02-11 |
| 1457983223 | Kayla Grotrian | Specialist/Technologist | 5440 Evard Rd, Fort Wayne, IN 46835-1796 | 2020-02-10 |
| 1730711680 | Danielle Rebecca Patton | Specialist/Technologist | 13303 Hawks View Blvd, Fort Wayne, IN 46845-8726 | 2020-02-09 |
| 1780220046 | Kelly Grayson | Specialist/Technologist | 1300 E Washington Center Rd, Fort Wayne, IN 46825-4556 | 2019-11-21 |
| 1265093280 | Emily Maria Giorgi | Specialist/Technologist | 2101 E Coliseum Blvd Ste 100, Fort Wayne, IN 46805-1499 | 2019-06-21 |
| 1194209791 | Autumn Brooke Meece | Specialist/Technologist | 5801 Meadows Dr Apt E, Fort Wayne, IN 46804-7639 | 2018-09-19 |
| 1407358377 | Bryan Black | Specialist/Technologist | 3946 Ice Way Fort Wayne, Fort Wayne, IN 46808 | 2018-03-06 |
| 1275049686 | Julianna Davis | Specialist/Technologist | 615 Vance Ave, Fort Wayne, IN 46805-2143 | 2017-12-20 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46805 |
Please comment or provide details below to improve the information on JILLIAN ANN HACKER.
| 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.