Betsy Kellerman, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

24-00854 Issued in KS

Practice address

12200 W 106TH St
400
Overland Park, KS 66215-2305

Phone

(913) 541-3365

Fax

(913) 541-5003

NPI assigned

Dec 3, 2014

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": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417564800000",
    "number": "1376940593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 W 106TH ST",
            "address_2": "400",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662152305",
            "telephone_number": "913-541-3365",
            "fax_number": "913-541-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 W 106TH ST",
            "address_2": "400",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662152305",
            "telephone_number": "913-541-3365",
            "fax_number": "913-541-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLERMAN",
        "first_name": "BETSY",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-03",
        "last_updated": "2014-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "24-00854",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2010028277",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Kobes, LLC
• Kekovole Consulting Group
• David Peter Keller, RN
• Lida Rose Keller, RN, BSN
• Steven G Keller, DPT
• Anne Kelley
• Chelsie Kelley
• Dwain E Kelley, PT
• Kelly R. Moore Therapy LLC
• Abigael F Kelly, AUD

• Athletic Trainer in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Athletic Trainer in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.