Individual provider Active NPI

Mary Kate Hedderman, MS ATC

  • Athletic Trainer
  • Albany, NY
National Provider Identifier
1265921845
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
000698-1 Issued in NY
Practice address
1400 Washington Ave
Albany, NY 12222-0100
Phone
(518) 591-8532
NPI assigned
May 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2018

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 000698-1 NY Primary

Addresses

Primary practice location

1400 Washington Ave
Albany, NY 12222-0100

Mailing address

1400 Washington Ave
Albany, NY 12222-0100
Phone (518) 591-8532

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
000698-1NYMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1265921845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WASHINGTON AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122220100",
            "telephone_number": "518-591-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WASHINGTON AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122220100",
            "telephone_number": "518-591-8532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDDERMAN",
        "first_name": "MARY KATE",
        "credential": "MS ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "000698-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; 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.