Active NPI
Kathleen H. Feuerbach, ATC
- Athletic Trainer
- Orlando, FL
National Provider Identifier
1386853992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL 1879
- Practice address
- 3100 Edgewater Dr
Orlando, FL 32804-3722 - Phone
- (407) 835-4900
- Fax
- (407) 245-2758
- NPI assigned
- May 21, 2007
- 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 | AL 1879 | FL | Primary |
Addresses
Primary practice location
3100 Edgewater Dr
Orlando, FL 32804-3722
Mailing address
111 E Harvard St
Orlando, FL 32804-5053
Phone (772) 834-8605
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2255A2300X | Other | FL | ATHLETIC TRAINER |
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 |
|---|---|---|---|
| AL 1879 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386853992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 E HARVARD ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328045053",
"telephone_number": "772-834-8605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 EDGEWATER DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328043722",
"telephone_number": "407-835-4900",
"fax_number": "407-245-2758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEUERBACH",
"first_name": "KATHLEEN",
"middle_name": "H.",
"name_prefix": "Miss",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL 1879",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATHLETIC TRAINER",
"identifier": "2255A2300X",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.