Individual provider Active NPI

Sherrill Hedlund, ATC

  • Athletic Trainer
  • Kent, WA
National Provider Identifier
1124539655
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
000100519 Issued in WA
Practice address
14333 SE 256TH PL
Kent, WA 98042-3622
Phone
(253) 631-0729
NPI assigned
Oct 24, 2017
Last updated
Oct 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

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 000100519 WA Primary

Addresses

Primary practice location

14333 SE 256TH PL
Kent, WA 98042-3622

Mailing address

14333 SE 256TH PL
Kent, WA 98042-3622
Phone (253) 631-0729

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
000100519WAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1124539655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14333 SE 256TH PL",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980423622",
            "telephone_number": "253-631-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14333 SE 256TH PL",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980423622",
            "telephone_number": "253-631-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDLUND",
        "first_name": "SHERRILL",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-24",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "000100519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; 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.