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Beth Ann Herrell , MS, ATC, LAT, CSCS

Specialist/Technologist - Athletic Trainer β€’ Fort Wayne, IN

Active NPI 1619945888 Individual Practitioner Female Practitioner
Practice location in NPPES

3946 Ice Way
Fort Wayne, IN 46808

Call 2602664007 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3946 Ice Way

Fort Wayne, IN 46808

Telephone 2602664007
Other Listings in Public Data

NPPES lists 1 additional practice-address record in Fort Wayne, IN. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2006

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Fort Wayne and Indiana

189 active clinicians are listed under Specialist/Technologist - Athletic Trainer with a practice address in Fort Wayne, IN (1,588 in Indiana).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Fort Wayne

0% of these 189 clinicians have the CMS telehealth indicator.

0% of these 189 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Specialist/Technologist - Athletic Trainer Primary Specialty

NUCC Taxonomy Code: 2255A2300X

License # reported to NPPES IN 36000171A

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Indiana Professional Licensing Agency.
Look Up on State Board Site

Secondary Practice Locations

11130 Parkview Circle Dr

Fort Wayne, IN 468451735

Phone: 2603594287

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

5 listed
Jodi Chambers , PA

Physician Assistant

NPI 1487646469

Physician Assistant

NPI 1578791398

Doctor of Osteopathic Medicine (D.O.)

NPI 1811444763

Physician Assistant (Certified), Licensed Athletic Trainer, Certified Athletic Trainer

Anne Fisher , PA-C

Physician Assistant

NPI 1346421864

Physician Assistant (Certified)

Benjamin Steele , PA-C

Physician Assistant

NPI 1710395736

Physician Assistant (Certified)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
βœ…
NPI Profile Active January 08, 2018

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location January 08, 2018

Registered at 3946 ICE WAY, FORT WAYNE, IN 46808 (Tel: 2602664007)

πŸ“
Updated Business Mailing Address January 08, 2018

Registered at 3946 ICE WAY, FORT WAYNE, IN 46808 (Tel: 2602664007)

πŸ‘€
Provider Name / Credentials Updated January 08, 2018

Recorded as BETH HERRELL, MS, ATC, LAT, CSCS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 08, 2018

Specialist/Technologist (license number reported to NPPES: IN 36000171A)

βœ…
NPI Profile Active March 03, 2016

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) March 03, 2016

Registered at 11130 PARKVIEW CIRCLE DR, FORT WAYNE, IN 468451735 (Tel: 2603594287)

πŸ“
Business Mailing Address (Initial Record) March 03, 2016

Registered at 3710 W OAK RD, BLUFFTON, IN 467149721 (Tel: 2607589257)

πŸ‘€
Provider Name / Credentials (Initial Record) March 03, 2016

Recorded as BETH HERRELL, MS, ATC, LAT, CSCS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 03, 2016

Specialist/Technologist (license number reported to NPPES: IN 36000171A)

🟒
Initial NPI Registration & Enumeration March 14, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1619945888
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 14, 2006
Last Update: March 17, 2018
Sole Proprietor: No

Mailing Address

3946 Ice Way

Fort Wayne, IN 46808

Phone: 2602664007

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.