Kaitlyn Nicole Edison

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2020035528 Issued in MO

Practice address

2549 Hackmann Rd
Saint Charles, MO 63303-5452

Phone

(636) 851-4900

NPI assigned

Apr 2, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1104388958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10717 SAINT BERNARD LN",
            "city": "SAINT ANN",
            "state": "MO",
            "postal_code": "630742519",
            "telephone_number": "314-625-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2549 HACKMANN RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035452",
            "telephone_number": "636-851-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2053 Zumbehl Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633032723",
            "country_code": "US",
            "telephone_number": "636-940-2900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDISON",
        "first_name": "KAITLYN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096005299",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2020035528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastern Missouri Alternative Sentencing Services, Inc.
• Catherine Eaton, LPC
• John J Ebeling II, DDS
• John Joseph Ebeling III, DDS
• Lucie Ecker, MA, PLPC
• Cameron R Edmond
• Sarah Rose Edwards, PT
• Mohsin Ehsan, M.D
• Kristin Eiken
• Lindsey Ann Eilers, LPC, CRADC

• Athletic Trainer in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.