Kelly Thomas Arends, M.ED, LAT, ATC,
Individual provider Active NPI Athletic Trainer · Fulton, MO
NPI 1336663111 · NPPES record last updated Dec 2, 2019
Key facts
- NPI
- 1336663111
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 2017010116 (MO)
- Practice address
- 501 Westminster Ave
Fulton, MO 65251-1299 - Phone
- (573) 592-5332
- NPI assigned
- Aug 2, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017010116 | MO | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2017010116 | MO | Yes |
Addresses
Primary practice location
501 Westminster Ave
Fulton, MO 65251-1299
Mailing address
411 Central Methodist SQ
Fayette, MO 65248-1104
Phone (660) 248-6978
Other practice location 1
411 Central Methodist Sq
Fayette, MO 65248-1104
Phone (660) 248-6978
Other providers in Fulton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.