Active NPI
Kimberly Latham, A.T.,C.
- Athletic Trainer
- Indianapolis, IN
National Provider Identifier
1386073021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36000469A
- Practice address
- 201 Pennsylvania Pkwy
Suite 100
Indianapolis, IN 46280-2301 - Phone
- (317) 817-1252
- NPI assigned
- Nov 4, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | 36000469A | IN | Primary |
Addresses
Primary practice location
201 Pennsylvania Pkwy
Suite 100
Indianapolis, IN 46280-2301
Mailing address
201 Pennsylvania Pkwy
Suite 100
Indianapolis, IN 46280-2301
Phone (317) 817-1252
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 |
|---|---|---|---|
| 36000469A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383523200000",
"number": "1386073021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 PENNSYLVANIA PKWY",
"address_2": "SUITE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462802301",
"telephone_number": "317-817-1252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 PENNSYLVANIA PKWY",
"address_2": "SUITE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462802301",
"telephone_number": "317-817-1252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATHAM",
"first_name": "KIMBERLY",
"name_prefix": "Mrs.",
"credential": "A.T.,C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-04",
"last_updated": "2013-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36000469A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.