Individual provider Active NPI

Kristin Milliette, ATC

  • Athletic Trainer
  • Tucson, AZ
National Provider Identifier
1124688403
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
ATR-008931 Issued in AZ
Practice address
565 N Cherry Ave
LSFF Athletic Training Room
Tucson, AZ 85719
Phone
(509) 699-0148
NPI assigned
Jun 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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 ATR-008931 AZ Primary

Addresses

Primary practice location

565 N Cherry Ave
LSFF Athletic Training Room
Tucson, AZ 85719

Mailing address

PO Box 41984
Tucson, AZ 85717-1984
Phone (509) 699-0148

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
ATR-008931AZMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1124688403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41984",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857171984",
            "telephone_number": "509-699-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 N CHERRY AVE",
            "address_2": "LSFF ATHLETIC TRAINING ROOM",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85719",
            "telephone_number": "509-699-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLIETTE",
        "first_name": "KRISTIN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "ATR-008931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.