Individual provider Active NPI

Katelin Gartner

  • Athletic Trainer
  • Libertyville, IL
National Provider Identifier
1184997017
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096003254 Issued in IL
Practice address
222 Park PL
Apt B
Libertyville, IL 60048-2271
Phone
(618) 713-6445
NPI assigned
Feb 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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 096003254 IL Primary

Addresses

Primary practice location

222 Park PL
Apt B
Libertyville, IL 60048-2271

Mailing address

222 Park PL
Apt B
Libertyville, IL 60048-2271
Phone (618) 713-6445

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
096003254ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1184997017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 PARK PL",
            "address_2": "APT B",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482271",
            "telephone_number": "618-713-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 PARK PL",
            "address_2": "APT B",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482271",
            "telephone_number": "618-713-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARTNER",
        "first_name": "KATELIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-23",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096003254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; 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.