Individual provider Active NPI

Kelly Christina Herman, ATC

  • Athletic Trainer
  • Springfield, MO
National Provider Identifier
1013201714
Registry record updated May 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2009020684 Issued in MO
Practice address
1229 E Seminole St
Springfield, MO 65804-2227
Phone
(417) 820-5610
Fax
(417) 820-5569
NPI assigned
May 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2011

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 2009020684 MO Primary

Addresses

Primary practice location

1229 E Seminole St
Springfield, MO 65804-2227

Mailing address

1229 E Seminole St
Springfield, MO 65804-2227
Phone (417) 820-5610

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

State licenses

LicenseStateTypeSpecialty
2009020684MOMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1013201714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 E SEMINOLE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042227",
            "telephone_number": "417-820-5610",
            "fax_number": "417-820-5569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 E SEMINOLE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042227",
            "telephone_number": "417-820-5610",
            "fax_number": "417-820-5569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "KELLY",
        "middle_name": "CHRISTINA",
        "name_prefix": "Mrs.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-31",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2009020684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; 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.