MITCHELL RAY BUERCK (NPI# 1992263123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992263123 |
Entity Type | Individual |
Full Name | MITCHELL RAY BUERCK |
Practice Address |
4940 Granite Dr Smithton IL 62285-3635 |
Practice Telephone | 6187194006 |
Mailing Telephone | 6187194006 |
Enumeration Date | 2019-03-06 |
Last Update Date | 2019-03-06 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | UNITED HEALTHCARE | 815976827 | 01 |
Street Address |
4940 GRANITE DR |
City | SMITHTON |
State | IL |
Zip Code | 62285-3635 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144730128 | Ashley Marie Hynes | Physician Assistant | 4059 Chestnut Oak Dr, Smithton, IL 62285 | 2017-10-04 |
1326419912 | Smithton Pharmacy Professional Corporation | Pharmacy | 3981 State Route 159, Smithton, IL 62285 | 2015-10-08 |
1295159184 | Ca Group, LLC | Internal Medicine | 4017 Illinois Route 159, Suite 101, Smithton, IL 62285 | 2014-02-12 |
1760819676 | Msa Alliance, LLC | Family Medicine | 4017 Illinois Route 159, Suite 101, Smithton, IL 62285 | 2013-10-09 |
1003159450 | Kristen Nicole Massey | Nurse Practitioner | 4017 State Route 159 Ste 101, Smithton, IL 62285 | 2013-04-04 |
1619280112 | Pc Associates, LLC | Family Medicine | 4017 Illinios Rt. 159, Ste 101, Smithton, IL 62285 | 2010-07-26 |
1225174642 | Amy Y Pfingsten | Speech-Language Pathologist | 215 Eugenia, Smithton, IL 62285 | 2007-01-30 |
1265526818 | Beverly Enterprises - Illinois, Inc. | Skilled Nursing Facility | 107 S. Lincoln, Smithton, IL 62285 | 2006-10-03 |
1316903008 | Thomas Gregory Bircher | Dentist | 504 North Main Street, Smithton, IL 62285 | 2006-04-22 |
1003285560 | Mattison N Perez | Physician Assistant | 4017 Illinois State Route 159, Suite 101, Smithton, IL 62285 | 2015-09-15 |
Find all providers in zip 62285 |
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 |
---|---|---|---|---|
1538771076 | Stacey Weathers-cannon | Specialist/Technologist | 650 Ingraham Ave, Calumet City, IL 60409-4236 | 2020-08-17 |
1104438621 | Abril Malagon | Specialist/Technologist | 1 S Greenwood Ave, Palatine, IL 60074-6328 | 2020-08-17 |
1265050678 | Megan Elsbree | Specialist/Technologist | 11819 Deacon Dr, Rockton, IL 61072-9411 | 2020-07-13 |
1013534437 | Nicole Rose Mondelli | Specialist/Technologist | 958 Tallgrass Dr, Bartlett, IL 60103-5071 | 2020-07-01 |
1740806413 | Megan Herter | Specialist/Technologist | 1513 Old Ivy Dr, Springfield, IL 62711-8156 | 2020-06-18 |
1164047239 | Madison Stagman | Specialist/Technologist | 280 Douglas Ave Apt 4, Mascoutah, IL 62258-2963 | 2020-06-14 |
1588286272 | Sarah Wegrzyn | Specialist/Technologist | 3040 S Wabash Ave, Chicago, IL 60616-3474 | 2020-05-15 |
1336761386 | Christine Louise Shebelski | Specialist/Technologist | 15203 Pulaski Rd, Midlothian, IL 60445-3755 | 2020-05-13 |
1386266633 | Kathryn Riordan | Specialist/Technologist | 221 Triton Ln, Naperville, IL 60540-7926 | 2020-05-09 |
1487276747 | Vianey Hernandez-ramirez | Specialist/Technologist | 4115 Howard St, Skokie, IL 60076-3749 | 2020-05-09 |
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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.