Kristen Marie O'Dore, M.ED., ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT003234 Issued in PA

Practice address

1101 City Ave
Wynnewood, PA 19096-3418

Phone

(610) 645-5089

NPI assigned

Jun 25, 2006

Last updated

Jul 8, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1073549457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 JACKSONVILLE RD",
            "address_2": "APT. 143F",
            "city": "HATBORO",
            "state": "PA",
            "postal_code": "190402630",
            "telephone_number": "610-960-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 CITY AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963418",
            "telephone_number": "610-645-5089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DORE",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "credential": "M.ED., ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT003234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norman a. Brest, MD Divison
• Cailin O'Connell
• Colleen E O'Connor, MD
• Lauren Marie O'Donnell, MD
• Ward J O'Donnell, MD
• Bonnie O'Hara, CRNP
• Kari O'Malley, CRNA
• Deborah Valdiserri O'Neill, LCSW
• Maureen McCormack O'Rourke, M.D.
• Leila A Obeid, M.D.

• Athletic Trainer in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; 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.