Active NPI
Kamden Phillips, ATC,LAT
- Athletic Trainer
- Decatur, TX
National Provider Identifier
1194241109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 609 Medical Center Dr
Decatur, TX 76234-3836 - Phone
- (940) 627-5921
- NPI assigned
- Aug 22, 2017
- Sex
- Male
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
609 Medical Center Dr
Decatur, TX 76234-3836
Mailing address
950 W Thompson St Apt 148
Decatur, TX 76234-2463
Phone (940) 210-2130
Other practice location 1
950 W Thompson St Apt 148
Decatur, TX 76234-2463
Phone (940) 210-2130
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1194241109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 W THOMPSON ST APT 148",
"city": "DECATUR",
"state": "TX",
"postal_code": "762342463",
"telephone_number": "940-210-2130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 MEDICAL CENTER DR",
"city": "DECATUR",
"state": "TX",
"postal_code": "762343836",
"telephone_number": "940-627-5921"
}
],
"practiceLocations": [
{
"address_1": "950 W Thompson St Apt 148",
"address_purpose": "LOCATION",
"city": "Decatur",
"state": "TX",
"postal_code": "762342463",
"country_code": "US",
"telephone_number": "940-210-2130",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHILLIPS",
"first_name": "KAMDEN",
"name_prefix": "Mr.",
"credential": "ATC,LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-22",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.