Kaitlyn Tyms, ATC. LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT006973 Issued in OH

Practice address

251 N Main St
Cedarville, OH 45314-8501

Phone

(908) 399-2802

NPI assigned

Apr 18, 2023

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": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1134816408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 S ALLISON AVE",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453853626",
            "telephone_number": "908-399-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 N MAIN ST",
            "city": "CEDARVILLE",
            "state": "OH",
            "postal_code": "453148501",
            "telephone_number": "908-399-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYMS",
        "first_name": "KAITLYN",
        "credential": "ATC. LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-18",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT006973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Cedarville, OH
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.