Individual provider Active NPI

Kristen Gaucker, M.S, LAT, ATC

  • Athletic Trainer
  • King of Prussia, PA
National Provider Identifier
1265849087
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
RT003679 Issued in PA
Practice address
435 Crossfield Rd
King of Prussia, PA 19406-2363
Phone
(610) 205-3905
Fax
(610) 205-3998
NPI assigned
Jul 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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 RT003679 PA Primary

Addresses

Primary practice location

435 Crossfield Rd
King of Prussia, PA 19406-2363

Mailing address

506 Green Hill Rd
Parkesburg, PA 19365-9191

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

LicenseStateTypeSpecialty
RT003679PAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1265849087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 GREEN HILL RD",
            "city": "PARKESBURG",
            "state": "PA",
            "postal_code": "193659191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 CROSSFIELD RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062363",
            "telephone_number": "610-205-3905",
            "fax_number": "610-205-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUCKER",
        "first_name": "KRISTEN",
        "name_prefix": "Mrs.",
        "credential": "M.S, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT003679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; 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.