Individual provider Active NPI

Cecilia Kieliszewski, AT

  • Athletic Trainer
  • Monroe, LA
National Provider Identifier
1285240028
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
308 Warhawk Way Ulm Athletics Department
Monroe, LA 71209-0001
Phone
(734) 545-2228
NPI assigned
Sep 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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 Primary

Addresses

Primary practice location

308 Warhawk Way Ulm Athletics Department
Monroe, LA 71209-0001

Mailing address

48282 Red Run Dr
Canton, MI 48187-5433

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

NPI Registry JSON

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1285240028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48282 RED RUN DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481875433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 WARHAWK WAY ULM ATHLETICS DEPARTMENT",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712090001",
            "telephone_number": "734-545-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIELISZEWSKI",
        "first_name": "CECILIA",
        "credential": "AT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.