Active NPI
Kellie J Smith, MS, ATC
- Athletic Trainer
- Concord, MA
National Provider Identifier
1346386703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1442
- Practice address
- 166 Main St
Concord Academy
Concord, MA 01742-2445 - Phone
- (978) 402-2341
- NPI assigned
- Jan 30, 2007
- 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 | 1442 | MA | Primary |
Addresses
Primary practice location
166 Main St
Concord Academy
Concord, MA 01742-2445
Mailing address
185 Main St.
Unit F
Concord, MA 01742
Phone (978) 402-2341
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346386703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "185 MAIN ST.",
"address_2": "UNIT F",
"city": "CONCORD",
"state": "MA",
"postal_code": "01742",
"telephone_number": "978-402-2341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "166 MAIN ST",
"address_2": "CONCORD ACADEMY",
"city": "CONCORD",
"state": "MA",
"postal_code": "017422445",
"telephone_number": "978-402-2341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "KELLIE",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "MS, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "1442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.