Bailey Nicole Roberts, AT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT005856 Issued in OH

Practice address

93 W Center St
Milford Center, OH 43045-8008

Phone

(810) 522-7136

NPI assigned

Sep 12, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1356860340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 W CENTER ST",
            "city": "MILFORD CENTER",
            "state": "OH",
            "postal_code": "430458008",
            "telephone_number": "810-522-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 W CENTER ST",
            "city": "MILFORD CENTER",
            "state": "OH",
            "postal_code": "430458008",
            "telephone_number": "810-522-7136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2625 Marine Dr",
            "address_purpose": "LOCATION",
            "city": "Pinckney",
            "state": "MI",
            "postal_code": "481699304",
            "country_code": "US",
            "telephone_number": "810-522-7136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BAILEY",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "AT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT005856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Jo Hall
• Leslie Kuebler
• Megan Litzke
• Starla Kay McWilliams
• Maria E Pla, M.D.
• Sarah Leasure
• Union Township
• Cameron Winn

• Athletic Trainer in Milford Center, OH
• Providers in Milford Center, OH by specialty
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; 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.