Kelsey Lynn Tilley, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

LAT-4279 Issued in NC

Practice address

2527 US 221a Hwy
Mooresboro, NC 28114-7698

Phone

(828) 657-9998

NPI assigned

Jan 31, 2022

Last updated

Jan 31, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thomas Jefferson Classical Academy

  • Local Education Agency (LEA)
  • Forest City, NC
  • NPI 1770222556
  NPD

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1336892355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2527 US 221A HWY",
            "city": "MOORESBORO",
            "state": "NC",
            "postal_code": "281147698",
            "telephone_number": "828-657-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2527 US 221A HWY",
            "city": "MOORESBORO",
            "state": "NC",
            "postal_code": "281147698",
            "telephone_number": "828-657-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "KELSEY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-4279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Allen Ralph, M.D.
• Rutherford Hospital Inc (Rutherford East Pharmacy)
• Rutherford Hospital, Inc. (Rutherford East Family Care)
• Rebecca Sellers
• Kim Szymanski
• Raph Voyles Jr.

• Athletic Trainer in Mooresboro, NC
• Providers in Mooresboro, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.