Mary Beth Kates, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT0074 Issued in MS

Practice address

520 Higgins Rd
Bentonia, MS 39040-9073

Phone

(205) 746-3113

NPI assigned

Oct 3, 2006

Last updated

Jun 7, 2016By 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

Other identifiers 2

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1124112875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 HIGGINS RD",
            "city": "BENTONIA",
            "state": "MS",
            "postal_code": "390409073",
            "telephone_number": "205-746-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 HIGGINS RD",
            "city": "BENTONIA",
            "state": "MS",
            "postal_code": "390409073",
            "telephone_number": "205-746-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATES",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MS",
            "license": "AT0074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSISSIPPI STATE LICENSE",
            "identifier": "AT0074",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATABOC",
            "identifier": "029402501",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Bentonia, MS
• Providers in Bentonia, MS by specialty
• Athletic Trainer in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.