Individual provider Active NPI

Kai D Washington, ATC, LAT

  • Athletic Trainer
  • Jackson, TN
National Provider Identifier
1275772709
Registry record updated Feb 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT0000001207 Issued in TN
Practice address
545 Lane Ave
Athletic Department
Jackson, TN 38301
Phone
(731) 426-7668
NPI assigned
Feb 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2009

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 AT0000001207 TN Primary

Addresses

Primary practice location

545 Lane Ave
Athletic Department
Jackson, TN 38301

Mailing address

131 Sunnyside Dr
Jackson, TN 38301-3337
Phone (731) 402-1375

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
AT0000001207TNMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233878400000",
    "number": "1275772709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 SUNNYSIDE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013337",
            "telephone_number": "731-402-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 LANE AVE",
            "address_2": "ATHLETIC DEPARTMENT",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38301",
            "telephone_number": "731-426-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "KAI",
        "middle_name": "D",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-06",
        "last_updated": "2009-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "AT0000001207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2009; 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.