Active NPI
Kaitlin Chrastek, ATC, LAT
- Athletic Trainer
- Columbia, SC
National Provider Identifier
1366071144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2813
- Practice address
- 4500 Stuart St
Columbia, SC 29207-5700 - Phone
- (803) 751-2160
- NPI assigned
- Apr 3, 2020
- 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 | 2813 | MN | Primary |
Addresses
Primary practice location
4500 Stuart St
Columbia, SC 29207-5700
Mailing address
224 Blanding St Unit 106
Columbia, SC 29201-2299
Phone (763) 772-7020
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2813 | MN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585872000000",
"number": "1366071144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 BLANDING ST UNIT 106",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292012299",
"telephone_number": "763-772-7020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 STUART ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292075700",
"telephone_number": "803-751-2160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRASTEK",
"first_name": "KAITLIN",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-03",
"last_updated": "2020-04-03",
"certification_date": "2020-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "2813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.