Active NPI
Kelly Okorocha, ATC, LAT
- Athletic Trainer
- Sulphur, LA
National Provider Identifier
1396384277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 3708 Maplewood Dr
Sulphur, LA 70663-6302 - Phone
- (337) 214-0029
- NPI assigned
- Dec 25, 2019
- Sex
- Male
- 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 | LA | Primary |
Addresses
Primary practice location
3708 Maplewood Dr
Sulphur, LA 70663-6302
Mailing address
3546 Taylor St
Lake Charles, LA 70607-2110
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577232000000",
"number": "1396384277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3546 TAYLOR ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706072110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3708 MAPLEWOOD DR",
"city": "SULPHUR",
"state": "LA",
"postal_code": "706636302",
"telephone_number": "337-214-0029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OKOROCHA",
"first_name": "KELLY",
"credential": "ATC, LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-12-25",
"last_updated": "2019-12-25",
"certification_date": "2019-12-25",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "LA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sulphur, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 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.