Active NPI
Kelly Lynn Havens, ATC
- Athletic Trainer
- Newport, KY
National Provider Identifier
1063521953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 13 Carothers Rd
Newport, KY 41071-2415 - Phone
- (859) 292-0001
- Fax
- (859) 292-0656
- NPI assigned
- Aug 30, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | KY | Primary |
Addresses
Primary practice location
13 Carothers Rd
Newport, KY 41071-2415
Mailing address
2619 Aspen Pines Dr
Wilder, KY 41071-0450
Phone (859) 801-7642
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063521953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2619 ASPEN PINES DR",
"city": "WILDER",
"state": "KY",
"postal_code": "410710450",
"telephone_number": "859-801-7642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 CAROTHERS RD",
"city": "NEWPORT",
"state": "KY",
"postal_code": "410712415",
"telephone_number": "859-292-0001",
"fax_number": "859-292-0656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAVENS",
"first_name": "KELLY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "KY",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.