Shannon Burke, MS, LAT, ATC
Individual provider Active NPI Athletic Trainer · Fort Riley, KS
NPI 1235513334 · NPPES record last updated Sep 10, 2024
Key facts
- NPI
- 1235513334
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 24-01517 (KS)
- Practice address
- 650 Huebner Rd
Fort Riley, KS 66442-4030 - Phone
- (847) 924-8887
- NPI assigned
- Jul 17, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096.003839 | IL | MD | Athletic Trainer |
| 24-01517 | KS | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 24-01517 | KS | Yes |
| Athletic Trainer | 2255A2300X | 096.003839 | IL |
Addresses
Primary practice location
650 Huebner Rd
Fort Riley, KS 66442-4030
Mailing address
923 Meadow LN
Junction City, KS 66441-3435
Phone (847) 924-8887
Other practice location 1
1515 W Jackson St
Apt 3
Macomb, IL 61455-3634
Phone (847) 924-8887
Other providers in Fort Riley, KS
- Stephen Gereard Brown
- Timera Lucinda Brown
- Nichole Marie Bruggman
- Dwayne Douglas Bryant
- Christel Lynn Labarge Burke
- Teresita Selga Busby
- Allen Byrne Jr.
- Crystal Caicedo
- Brian David Calkins
- Jesus Camacho Maldonado
All providers in Fort Riley, KS · Athletic Trainer in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.