Active NPI
Kandice Vinson, ATC
- Athletic Trainer
- Beaverton, OR
National Provider Identifier
1366089435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-AT-10141419
- Practice address
- 9923 SW Arctic Dr
Beaverton, OR 97005-4194 - Phone
- (503) 646-8482
- NPI assigned
- Dec 7, 2019
- 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 | AT-AT-10141419 | OR | Primary |
Addresses
Primary practice location
9923 SW Arctic Dr
Beaverton, OR 97005-4194
Mailing address
5230 SE Oakland Ave
Milwaukie, OR 97267-5019
Phone (503) 388-8691
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 |
|---|---|---|---|
| AT-AT-10141419 | OR | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adapt Training | Past | Accepting new patients | |
| Adapt Training | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Massage Therapist
- Beaverton, OR
- NPI 1043545031
-
- Multi-Specialty Clinic/Center
- Beaverton, OR
- NPI 1770769424
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575676800000",
"number": "1366089435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5230 SE OAKLAND AVE",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972675019",
"telephone_number": "503-388-8691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9923 SW ARCTIC DR",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970054194",
"telephone_number": "503-646-8482"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINSON",
"first_name": "KANDICE",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-07",
"last_updated": "2019-12-07",
"certification_date": "2019-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OR",
"license": "AT-AT-10141419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
- Giomar Z Villalba Aguilar
- Juan Pablo Villalobos Sr., PSS,CRM,CADC-R
- Arianna Villanueva Navarro
- Hazel Tordesillas Villarosa
- Natalie Gabrielle Villarreal
- Andrea Q Vintro, MS, RD, CSSD, LD
- Mariana Viola-Limin, BA
- Virginia Garcia Memorial Health Center
- Virginia Garcia Memorial Health Center
- Virginia Garcia Memorial Health Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.