Emilee Berry, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A160286048 Issued in WA

Practice address

650 Joel Dr
Fort Campbell, KY 42223-5318

Phone

(270) 798-8400

NPI assigned

Apr 1, 2019

Last updated

Aug 30, 2022By the provider in NPPES

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

• Emilee Mackey Former name

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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1174085195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20316 RUSTIC VIEW RD SE",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982727607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "EMILEE",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A160286048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILEE",
            "last_name": "MACKEY",
            "credential": "LAT, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Ruth Bellenger, CRNA
• Robert Bendorf
• Mark Richard Benne, DDS
• Elizabeth Berends, NURSE PRACTITIONER
• Eric Wilhelm Berg III, M.D.
• Troy Patrick Bettencourt, PA
• Bertha Ann Betz, LPN
• Bradley Thomas Biggar
• Robert Wade Binion, MSOTR
• Alicia Ivon Birch, MA, LCPC

• Athletic Trainer in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Athletic Trainer in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.