Krista Haidle, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1069 Issued in SC

Practice address

2400 Jackson Blvd
Columbia, SC 29207-7015

Phone

(412) 721-6473

NPI assigned

Apr 17, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1285254425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 LANDMARK DR APT 22E",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292104531",
            "telephone_number": "412-721-6473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 JACKSON BLVD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292077015",
            "telephone_number": "412-721-6473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDLE",
        "first_name": "KRISTA",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-17",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "1069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khaidle@corahealth.com",
            "affiliation": "N",
            "address_1": "108 Palmetto Park Blvd Ste B",
            "city": "Lexington",
            "state": "SC",
            "country_code": "US",
            "postal_code": "290727969",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khaidle@corahealth.com",
            "affiliation": "N",
            "address_1": "108 Palmetto Park Blvd Ste B",
            "city": "Lexington",
            "state": "SC",
            "country_code": "US",
            "postal_code": "290727969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Adam Hahn, DMD
• Christina Faith Hahn, LISW-CP
• Jenna Callaham Hahn
• Paul F Hahn, DMD
• Tareq Haidary, M.D.
• Matthew Tyrone Haigh, NP
• Gregory Antonio Haigler
• Edward Cantey Haile Jr., MD
• Elizabeth Stokely Haile, M.D.
• Kourtland Haile

• Athletic Trainer in Columbia, SC
• Providers in Columbia, SC by specialty
• Athletic Trainer in South Carolina

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