Kelly Lynn Bachus, MED, ATC
Individual provider Active NPI Athletic Trainer · Madison, WI
NPI 1013088558 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1013088558
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 1155 (TN)
- Practice address
- 500 Lincoln Dr
Madison, WI 53706-1314 - Phone
- (608) 515-3893
- Fax
- (608) 265-4736
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1155 | TN | MD | Social Worker |
| AT0360 | MS | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1155 | TN | Yes |
| Athletic Trainer | 2255A2300X | AT0360 | MS |
Addresses
Primary practice location
500 Lincoln Dr
Madison, WI 53706-1314
Mailing address
6633 Gettysburg Dr
Madison, WI 53705-4206
Phone (512) 297-0277
Other providers in Madison, WI
- Carrie Bach
- Anne R Bachhuber
- Brian G Bachhuber
- Deborah Ann Bachmann
- Vicki Bachmann
- Alok Bachuwar
- Back & Neck Wellness Center Inc.
- Emily Backes
- Katelyn Marie Backhaus
- Michelle N. Backs
All providers in Madison, WI · Athletic Trainer in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.