Active NPI
Maxine Weber, MS, ATC, CSCS
- Athletic Trainer
- Fort Campbell, KY
National Provider Identifier
1194239152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT007088
- Practice address
- 650 Joel Dr
Fort Campbell, KY 42223-5318 - Phone
- (973) 459-9937
- NPI assigned
- Nov 28, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT007088 | PA | Primary |
Addresses
Primary practice location
650 Joel Dr
Fort Campbell, KY 42223-5318
Mailing address
3301 Royster LN Apt 901
Clarksville, TN 37042-7744
Phone (973) 459-9937
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT007088 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694563200000",
"number": "1194239152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3301 ROYSTER LN APT 901",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370427744",
"telephone_number": "973-459-9937"
},
{
"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": "973-459-9937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEBER",
"first_name": "MAXINE",
"credential": "MS, ATC, CSCS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-28",
"last_updated": "2023-09-13",
"certification_date": "2023-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT007088",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.