Active NPI
Katherene M Larue-Martin, AT, MPH
- Athletic Trainer
- Springboro, OH
National Provider Identifier
1376861880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0002904
- Practice address
- 172 Hillcrest Dr
Springboro, OH 45066-8416 - Phone
- (937) 748-3079
- NPI assigned
- May 7, 2010
- 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 | 0002904 | OH | Primary |
Addresses
Primary practice location
172 Hillcrest Dr
Springboro, OH 45066-8416
Mailing address
172 Hillcrest Dr
Springboro, OH 45066-8416
Phone (740) 815-2618
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 |
|---|---|---|---|
| 0002904 | OH | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554854400000",
"number": "1376861880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "172 HILLCREST DR",
"city": "SPRINGBORO",
"state": "OH",
"postal_code": "450668416",
"telephone_number": "740-815-2618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "172 HILLCREST DR",
"city": "SPRINGBORO",
"state": "OH",
"postal_code": "450668416",
"telephone_number": "937-748-3079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARUE-MARTIN",
"first_name": "KATHERENE",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "AT, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-07",
"last_updated": "2019-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "0002904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springboro, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.