Individual provider Active NPI

Kristen Watson, ATC

  • Athletic Trainer
  • Des Moines, IA
National Provider Identifier
1275075673
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
083653 Issued in IA
Practice address
450 Laurel St
Des Moines, IA 50314-3045
Phone
(515) 323-6485
Fax
(515) 323-6486
NPI assigned
Nov 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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 083653 IA Primary

Addresses

Primary practice location

450 Laurel St
Des Moines, IA 50314-3045

Mailing address

450 Laurel St
Des Moines, IA 50314-3045
Phone (515) 323-6485

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
083653IAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1275075673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 LAUREL ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143045",
            "telephone_number": "515-323-6485",
            "fax_number": "515-323-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 LAUREL ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143045",
            "telephone_number": "515-323-6485",
            "fax_number": "515-323-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KRISTEN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-16",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "083653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; 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.