Active NPI
Kimberly Bentley, ATC
- Athletic Trainer
- Toledo, OH
National Provider Identifier
1275601643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT 001719
- Practice address
- 4345 Secor Rd
Toledo, OH 43623-4233 - Phone
- (419) 291-2097
- Fax
- (419) 480-8423
- NPI assigned
- Dec 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT 001719 | OH | Primary |
Addresses
Primary practice location
4345 Secor Rd
Toledo, OH 43623-4233
Mailing address
19 W Crawford Ave
Toledo, OH 43612-3425
Phone (419) 478-1130
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
| License | State | Type | Specialty |
|---|---|---|---|
| AT 001719 | OH | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184803200000",
"number": "1275601643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 W CRAWFORD AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436123425",
"telephone_number": "419-478-1130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4345 SECOR RD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436234233",
"telephone_number": "419-291-2097",
"fax_number": "419-480-8423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTLEY",
"first_name": "KIMBERLY",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "AT 001719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.