Individual provider Active NPI

Kendall Morgan D'India, LAT, ATC

  • Athletic Trainer
  • Huntersville, NC
National Provider Identifier
1093382210
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
LAT-3999 Issued in NC
Practice address
13245 Reese Blvd W Ste 100
Huntersville, NC 28078-6390
Phone
(704) 316-5096
NPI assigned
Jun 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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 LAT-3999 NC Primary

Addresses

Primary practice location

13245 Reese Blvd W Ste 100
Huntersville, NC 28078-6390

Mailing address

17305 Grand Central Way
Cornelius, NC 28031-8117
Phone (925) 519-8962

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmdindia@novanthealth.org

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
LAT-3999NCMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1093382210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17305 GRAND CENTRAL WAY",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280318117",
            "telephone_number": "925-519-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13245 REESE BLVD W STE 100",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786390",
            "telephone_number": "704-316-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'INDIA",
        "first_name": "KENDALL",
        "middle_name": "MORGAN",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-3999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmdindia@novanthealth.org",
            "affiliation": "N",
            "address_1": "13245 Reese Blvd W Ste 100",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280786390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.