Individual provider Active NPI

Shelley Kreeger, AT

  • Athletic Trainer
  • Van Wert, OH
National Provider Identifier
1215313846
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT000329 Issued in OH
Practice address
140 Fox Rd
Suite 101
Van Wert, OH 45891-2475
Phone
(419) 238-8691
Fax
(419) 238-8671
NPI assigned
Aug 5, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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 AT000329 OH Primary

Addresses

Primary practice location

140 Fox Rd
Suite 101
Van Wert, OH 45891-2475

Mailing address

140 Fox Rd
Suite 101
Van Wert, OH 45891-2475
Phone (419) 238-8691

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
AT000329OHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1215313846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 FOX RD",
            "address_2": "SUITE 101",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458912475",
            "telephone_number": "419-238-8691",
            "fax_number": "419-238-8671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 FOX RD",
            "address_2": "SUITE 101",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458912475",
            "telephone_number": "419-238-8691",
            "fax_number": "419-238-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREEGER",
        "first_name": "SHELLEY",
        "credential": "AT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT000329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Wert, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; 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.