Katelyn Maniaci, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0126002150 Issued in VA

Practice address

1860 Town Center Dr Ste 300
Town Center Othopaedic Associates
Reston, VA 20190-5900

Phone

(703) 483-4671

NPI assigned

Jul 31, 2014

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

State licenses

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406764800000",
    "number": "1114335387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4717 LAFITTE CT",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223121612",
            "telephone_number": "810-599-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 TOWN CENTER DR STE 300",
            "address_2": "TOWN CENTER OTHOPAEDIC ASSOCIATES",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905900",
            "telephone_number": "703-483-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIACI",
        "first_name": "KATELYN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126002150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nidhi K Malik, MD
• Norma R Maltez
• John P Mamana, M.D.
• Catherine M. Manfredi, NP
• Andrea C Mangram Simmons
• Karina Manicka
• Ruth Avigan Mann, M.D.
• Jamil Manna, RPH
• Arya Mazda Mansouri, DDS
• Allyson Manuyag

• Athletic Trainer in Reston, VA
• Providers in Reston, VA by specialty
• Athletic Trainer in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.