Kenneth Brown III, LAT, ATC
Individual provider Active NPI Athletic Trainer · Olathe, KS
NPI 1023487121 · NPPES record last updated Jul 23, 2016
Key facts
- NPI
- 1023487121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 24-01065 (KS)
- Practice address
- 1500 S Sioux Dr
Olathe, KS 66062-2416 - Phone
- (913) 620-4715
- NPI assigned
- Sep 18, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24-01065 | KS | MD | Athletic Trainer |
| 2015032420 | MO | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2015032420 | MO | |
| Athletic Trainer | 2255A2300X | 24-01065 | KS | Yes |
Addresses
Primary practice location
1500 S Sioux Dr
Olathe, KS 66062-2416
Mailing address
1500 S Sioux Dr
Olathe, KS 66062-2416
Phone (913) 620-4715
Other providers in Olathe, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2016. 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.