Active NPI
Kisha T Adade, RYT 200 TRAINING
- Athletic Trainer
- Townsend, GA
National Provider Identifier
1023714995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 394581
- Practice address
- 1285 Swamp Rd SE
Townsend, GA 31331-4235 - Phone
- (912) 424-4643
- NPI assigned
- Feb 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orientation and Mobility Training Rehabilitation Counselor | 225CX0006X | 394581 | GA | |
| Day Training/Habilitation Specialist | 373H00000X | 394581 | GA | |
| Athletic Trainer | 2255A2300X | 394581 | GA | Primary |
Addresses
Primary practice location
1285 Swamp Rd SE
Townsend, GA 31331-4235
Mailing address
1285 Swamp Rd SE
Townsend, GA 31331-4235
Phone (912) 424-4643
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 394581 | Other | YOGA ALLIANCE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 394581 | GA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675296000000",
"number": "1023714995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1285 SWAMP RD SE",
"city": "TOWNSEND",
"state": "GA",
"postal_code": "313314235",
"telephone_number": "912-424-4643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1285 SWAMP RD SE",
"city": "TOWNSEND",
"state": "GA",
"postal_code": "313314235",
"telephone_number": "912-424-4643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADADE",
"first_name": "KISHA",
"middle_name": "T",
"credential": "RYT 200 TRAINING",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-02",
"last_updated": "2023-02-02",
"certification_date": "2023-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "225CX0006X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor, Orientation and Mobility Training Provider",
"state": "GA",
"license": "394581",
"primary": false
},
{
"code": "373H00000X",
"taxonomy_group": "",
"desc": "Day Training/Habilitation Specialist",
"state": "GA",
"license": "394581",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "394581",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "YOGA ALLIANCE",
"identifier": "394581",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Townsend, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.