Kayla Redko, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2515 Issued in MN

Practice address

350 Lafayette Ave SE
Grand Rapids, MI 49503-4656

Phone

(616) 456-8515

NPI assigned

Sep 17, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kayla Schrupp Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mary Free Bed Rehabilitation Hospital

  • Rehabilitation Hospital
  • Grand Rapids, MI
  • NPI 1730133463
  NPD (past)

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610841600000",
    "number": "1124420518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 S LOCUST ST",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493481309",
            "telephone_number": "612-581-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 LAFAYETTE AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034656",
            "telephone_number": "616-456-8515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1903 W Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490085200",
            "country_code": "US",
            "telephone_number": "269-387-3355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDKO",
        "first_name": "KAYLA",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2021-01-17",
        "certification_date": "2021-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "2515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "SCHRUPP",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Kniowski Redder, RDN
• Haritha Ganesh Reddy, M.D.
• Miranda Reddy, NP
• Bradley J Redeker, LMSW, APBCC, CCTP
• Austin James Redick, PA-C
• Alexander William Redman, MD
• Leslie Yvonne Redmon, REGISTERED NURSE
• Redmond Counseling LLC
• Jodi Redmond, NCES
• Nikota Daniel Redmond, PHARMD

• Athletic Trainer in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Athletic Trainer in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.