Individual provider Active NPI

Kimberly Coronel, MS, ATC

  • Athletic Trainer
  • Ashburn, VA
National Provider Identifier
1013162353
Registry record updated Dec 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126000674 Issued in VA
Practice address
42910 Winkle Dr
Ashburn, VA 20147-7470
Phone
(703) 598-7997
NPI assigned
Dec 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0126000674 VA Primary

Addresses

Primary practice location

42910 Winkle Dr
Ashburn, VA 20147-7470

Mailing address

42910 Winkle Dr
Ashburn, VA 20147-7470
Phone (703) 598-7997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0126000674VAMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228089600000",
    "number": "1013162353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42910 WINKLE DR",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201477470",
            "telephone_number": "703-598-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42910 WINKLE DR",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201477470",
            "telephone_number": "703-598-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONEL",
        "first_name": "KIMBERLY",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126000674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.