Active NPI
Kristen Jill Gill, MSL, MSED, ATC
- Athletic Trainer
- Woburn, MA
National Provider Identifier
1295796548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 25MT00121400
- Practice address
- 300 Tradecenter Ste 1650
Woburn, MA 01801-1884 - Phone
- (781) 935-2655
- NPI assigned
- Mar 28, 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 | 25MT00121400 | NJ | Primary |
Addresses
Primary practice location
300 Tradecenter Ste 1650
Woburn, MA 01801-1884
Mailing address
41 Windsor Dr
Tewksbury, MA 01876-2664
Phone (201) 401-7304
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
- Credentials
- Master of Science - Law
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MT00121400 | NJ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419206400000",
"number": "1295796548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 WINDSOR DR",
"city": "TEWKSBURY",
"state": "MA",
"postal_code": "018762664",
"telephone_number": "201-401-7304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 TRADECENTER STE 1650",
"city": "WOBURN",
"state": "MA",
"postal_code": "018011884",
"telephone_number": "781-935-2655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILL",
"first_name": "KRISTEN",
"middle_name": "JILL",
"credential": "MSL, MSED, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-28",
"last_updated": "2014-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NJ",
"license": "25MT00121400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.