Individual provider Active NPI

Alan Kerstiens, LAT, ATC

  • Athletic Trainer
  • Stephenville, TX
National Provider Identifier
1053021402
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT9073 Issued in TX
Practice address
1333 W Washington St
Stephenville, TX 76401-4168
Phone
(812) 639-7984
NPI assigned
Nov 28, 2022
Last updated
Nov 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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 AT9073 TX Primary

Addresses

Primary practice location

1333 W Washington St
Stephenville, TX 76401-4168

Mailing address

8388 E Ellsworth Rd
Celestine, IN 47521-9606

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
AT9073TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1053021402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8388 E ELLSWORTH RD",
            "city": "CELESTINE",
            "state": "IN",
            "postal_code": "475219606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 W WASHINGTON ST",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764014168",
            "telephone_number": "812-639-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSTIENS",
        "first_name": "ALAN",
        "credential": "LAT,  ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT9073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stephenville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.